Columbia  ^nifaergitp 

intljeCitpofjaetogorfe 

COLLEGE  OF  PHYSICIANS 
AND   SURGEONS 


Reference  Library 

Given  by 


^  Hr;:7^n^^A 


state  Boar&  lEiamlnation  Scries. 
QUESTIONS  IN 

PHYSIOLOGY  AND  HYGIENE 

ASKED    AT    THE    EXAMINATIONS    HELD    BY   THE 

NEW  YORK  STATE  BOARD  OF  MEDICAL  EXAMINERS, 

COMPLETE,  WITH  REFERENCES  AND  ANSWERS 

TO    EVERY    QUESTION. 


COMPILED    AND    EDITED    BY 

R.  J.  E.  SCOTT,  A.M.,  M.D.,  B.C.L., 

attending  gynecologist,  demilt  dispensary;  instructor  in  gynecology 

at  the  new  york  school  of  clinical  medicine;  chief  of  the 

gynecological  clinic  at  the  west  side   german 

dispensary;  and  late  attending  physician, 

bellevue  dispensary,  new  york. 


LEA  BROTHERS  &  CO., 
NEW    YORK    A^vD    PHir^ADELPHI A. 


</i 


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->■ 


Entered  according  to  the  Act  of  Congress,  in  the  year  1905,  by 

LEA   BROTHERS   &   CO., 
In  the  Office  of  the  Librarian  of  Congress.     All  rights  reserved. 


DORNAN,   PRINTER. 


PREFACE. 


This  series  is  intended  to  aid  medical  students  and 
practitioners  in  preparing  to  pass  the  State  Board  Examina- 
tions. The  volumes  are  of  the  nature  of  neither  text-books 
nor  quiz  compends.  From  the  latter  they  differ  materially  in 
that  they  do  not  contain  questions  which  might  be  asked,  or 
which  ought  to  be  asked,  or  which,  if  asked,  could  be  answered 
from  some  given  text-book.  They  simply  contain  all  the 
questions  which  have  been  asked  and  are  being  asked  at  the 
New  York  State  Board  Examinations,  and  they  thus  give  an 
accurate  idea  of  the  scope  of  the  examination  and  of  the  re- 
quirements of  the  examiners. 

Although  intended  primarily  for  use  by  candidates  pre- 
paring for  the  examinations  held  by  the  New  York  State 
Board,  this  volume  will  also  serve  as  a  guide  for  correspond- 
ing examinations  conducted  elsewhere,  for  a  careful  survey 
of  the  papers  set  in  most  of  the  other  States  will  show  a 
marked  similarity  to  and  almost  monotonous  repetition  of 
the  questions  contained  in  this  volume. 

Students  are  advised  to  use  this  series  as  a  companion 
to  their  text-books,  to  mark  the  questions  they  cannot 
answer  and  to  learn  the  answers  thereto,  to  write  out  in  full 
all  definitions,  tables  of  composition,  etc.,  and  such  other  facta 
as  they  have  found  from  experience  are  likely  to  be  forgotten 
in  the  recitation  room.     For  this  purpose  these  volumes  are 


iv  PREFACE. 

arranged  so  as  to  leave  right-hand  pages  blank  and  are  printed 
on  paper  prepared  for  the  use  of  either  ink  or  pencil.  Upon 
the  eve  of  examination,  students  will  find  a  review  of  the  ques- 
tions in  these  volumes,  in  connection  with  their  personal  notes, 
an  efficient  and  ready  means  of  preparation  to  successfully 
meet  the  test. 

The  method  adopted  of  supplying  answers  to  questions  by 
citing  references  to  standard  text-books  is  the  outcome  of 
careful  thought,  as  furnishing  the  student  with  much  fuller 
information  than  could  be  couched  in  the  few  lines  of  reply 
admissible  in  such  volumes.  In  selecting  works  for  refer- 
ence, care  has  been  taken  to  choose  those  in  most  general 
use  and  of  unquestioned  authority. 

Appended  to  each  question  is  an  indication  of  the  dates 
upon  which  it  has  been  asked,  thus  showing  its  frequency 
and  relative  importance. 

The  remaining  volumes  of  this  series  are  in  active  prepa- 
ration, and  will  appear  at  an  early  date. 

R.  J.  E.  Scott. 


CONTENTS. 


A.  PHYSIOLOGY. 

PAGE 

I.  The  Phexomexa  of  Life. 

1.  Human  Physiology  (Q.  1  and  2)    .          .          .          .  '  18 

2.  Life  and  Death  (Q.  3) 18 

3.  Protoplasm  (Q.  4  to  9) 18 

4.  Cells  (Q.  10  to  23) 19 

II.  The  Structure  of  the  Elementary  Tissues. 

1.  Epithelial  Tissues  (Q.  24  to  31)     .  .  .  .       20 

2.  Connectiye  Tissues      .  .  ....        22 

(a)  Fibrous  (Q.  32  to  38). 
(h)  Cartilage  (Q.  39  to  43). 
(c)  Bone  (Q.  44  to  48).  - 

3.  The  Teeth  (Q.  49  to  54) 31 

4.  Muscular  Tissues  (Q.  55  to  61)        .  .  .  .       35 

5.  Nervous  Tissues  (Q.  62  to  64)        .  .  .  .       36 
III.  The  Chemical  Composition  of  the  Body  (Q.  65)  .          .       36 

lY.  The  Blood  and  the  Circulation. 

1.  The  Blood 36 

(a)  Plasma  and  Coagulation  of  the  Blood  (Q. 

66  to  81). 
(6)  Corpuscles  (Q.  82  to  90). 

(c)  Haemoglobin  (Q.  91  and  92). 

(d)  Stains  (Q.  93). 

(e)  Arterial  and  Venous  Blood  (Q.  94  to  97). 
(/)  Uses  of  the  Blood  (Q.  98  to  102). 

2.  The  Circulation  of  the  Blood  (Q.  103  to  119)     .  .       41 

3.  The  Heart 45 

(a)  Topography  and  Structure  (Q.  120  to  124). 

(b)  The  Sounds  of  the  Heart  (Q.  125  to  131). 

(c)  The  Impulse  of  the  Heart  (Q.  132  to  137). 

(d)  Blood  Pressure  (Q.  138  to  140). 

(e)  The  Pulse  (Q.  141  to  144). 

4.  The  Bloodvessels  ......       50 

(a)  Structure  (Q.  145  to  151). 

(b)  Venous  Flow  (Q.  152  and  153). 

(c)  Variations  in  the  Composition  of  the  Blood 

(Q.  154  and  155). 

(d)  The  Erectile  Tissues  (Q.  156). 
V.  Respiration. 

1.  The  Respiratory  Apparatus  (Q.  157)      ...       53 

2.  The  Respiratory  Mechanism  (Q.  158  to  175)   .  .       53 

3.  Respiratory  Changes     ......       55 

(a)  In  the  Blood  and  the  Circulation  (Q.  176 

to  183). 
(6)  In  the  Air  Breathed  (Q.  184  to  190). 


vi  CONTENTS. 

PAGE 

4.  Quantity  of  Air  Required  (Q.  191  to  194)        .  .  57 

5.  Asphyxia,  Dyspnoea,  Syncope,  etc.  (Q.  195  to  203)  .  57 

6.  The  Respiratory  Centre  (Q.  204  and  205)        .  .  60 

7.  Respiration  a  Proof  of  Live  Birth  (Q.  206)      .  .  60 
VI.  Digestion,  Food,  and  Nutrition. 

1.  Digestion     .  .  .  .....        61 

(a)  Deglutition  (Q.  207  to  210). 

{h)  The  Epiglottis  (Q.  211). 

(c)  The  Saliva  (Q.  212  to  215). 

id)  The  Stomach  (Q.  216  to  228). 

(e)  Vomiting  (Q.  229). 

(/)  The  Pancreas  (Q.  230  to  240). 

(gr)  The  Liver  (Q.  241  to  258). 

Qh)  The  Intestines  (Q.  259  to  279). 

1%)  The  Digestion  of  Food  (Q.  280  to  288). 

2.  Absorption  .......       75 

(a)  Methods  of  Absorption  (Q.  289  to  295). 
{h)  Digestive  Fluids  and  Ferments  (Q.  296  to 

300). 
(c)  The  Feces  (Q.  301  to  303). 
Id)  Rectal  Feeding  (Q.  304  and  305). 

3.  The  Lymphatic  System  .....       79 

\a)  The  Lymph  Flow  (Q.  306  to  316). 
(6)  The  Lymph  and  Chyle  (Q.  317  to  321). 

4.  Foods 81 

(a)  Classification  of  Foods  (Q.  322  to  326). 

(6)  Objects  of  Cooking  Food  (Q.  327  to  331). 

(c)  Food  Values  (Q.  332  and  333). 

{d)  Alcohol  (Q.  334  to  336). 

(e)  Influence  of  Food  on  Nutrition  (Q.  337  to 

339). 
(/)  Milk,  and  Infant  Feeding  (Q.  340  to  349). 
ig)  Diet  in  Old  Age  (Q.  350  and  351). 
Qi)  Variations  in  Diet  (O.  352  to  357). 
{%)  Obesity  (Q.  358  to  365). 
VII.  Excretion. 

1.  The  Kidnevs  and  the  Urine    .  .  .  .  .        91 

(a)  the  Kidneys  (Q.  366  to  368). 

(6)  Excretion  of  the  Urine  (Q.  369  to  375). 

(c)  The  Urine  (Q.  376  to  381). 

{d)  Urea  (Q.  382  to  384). 

2.  The  Skin 94 

(a)  The  Functions  of  the  Skin  (Q.  385  to  390). 
(6)  Perspiration  (Q.  391  to  393). 
VIII.  Metabolism  of  the  Tissues. 

1.  Muscular  Metabolism     ......       95 

(a)  Muscular  Contraction  (Q.  394  to  404). 
(&)  Rigor  Mortis  (Q.  405  to  409). 

2.  Glandular  Metabolism  (Q.  410  to  432)     ...       97 

3.  The  Ductless  Glands  (Q.  433  to  438)         .  .  .100 


cox  TEXTS.  vii 

PAGE 

IX.  Animal  Heat  (Q.  439  to  454) 101 

X.  The  Productiox  of  the  Voice  (Q.  455  to  464)  .  .  104 

XI.  The  Nervous  System. 

1.  The  Spinal  Cord  and  its  Xerves      ....  106 

(a)  Classification  of  Xerves  (Q.  465  and  466). 
(6)  Reflex  Action  (Q.  467  to  475). 

(c)  The  Spinal  Cord  and  Spinal  Xerves  (Q.  476 

to  486). 

(d)  The  Vasomotor  Xerves  (Q.  487  and  488). 

(e)  The  Medulla  Oblongata  (Q.  489). 

2.  The  Cranial  Xerves 112 

(a)  II.  Xerve  (Q.  490). 

(6)  III.  Xerve  (Q.  491  and  492). 

(c)  IV.  Xerve  (Q.  493). 

(d)  V.  Xerve  (Q.  494). 

(e)  VI.  Xerve  (Q.  495). 
(/)  VII.  Xerve  (Q.  496). 
(g)  IX.  Xerve  (Q.  497). 

(h)  X.  Xerve  (Q.  498  to  501). 
(i)  General  (Q.  502  and  503). 

3.  The  Cerebrum 113 

(a)  The  Membranes  (Q.  504). 

(6)  The  Cerebrospinal  Fluid  (Q.  505). 

(c)  The  Functions  of  the  Cerebnmi  (Q.  506  to 

510). 

(d)  The  Motor  Areas  (Q.  511  and  512). 

(e)  The  Sensory-  Centres  (Q.  513  to  515). 
(/)  The  Centre^for  Speech  (Q.  516  and  517). 

4.  Sleep  (Q.  518  to  524) 115 

5.  The  Cerebellum  (Q.  525  to  527)       .  .  .  .118 

6.  The  Sympathetic  System  (Q.  528  to  532)      .  .118 
XII.  The  Senses. 

1.  Common  Sensations       .  .  .  .  .119 

(a)  Pain  (O.  533  and  534). 

(b)  Hunger  and  Thirst  (Q.  535). 

2.  Special  Sensations         .  .  .  .  .  .120 

(a)  General  (Q.  536). 
(6)  Touch  (Q.  537). 

(c)  Smell  (Q.  538  to  540). 

(d)  Hearing  (Q.  541  to  551). 

(e)  Sight  (Q.  552  to  564). 
XIII.  The  Reproductive  Organs. 

1.  Female  (Q.  565  to  577) 124 

2.  Male  (Q.  578  to  585) 121) 

XIV.  Miscell.\neous  (Q.  586  to  604) 127 


VIU 


CONTENTS. 


B.  HYGIENE. 

I,  Diseases  in  General  (Q.  605  to  624) 
II.  Special  Diseases 

1.  Diphtheria  (Q.  625  to  633) 

2.  Tuberculosis  (Q.   634  to  640) 

3.  Tj^phoid  Fever  (Q.  641  to  647) 

4.  Scarlet  Fever  (Q..  648  and  649) 

5.  Miscellaneous  (Q.  650  to  655) 

6.  Scurvy  (Q.  656) 

7.  Heat  Stroke  (Q.  657) 

8.  Yellow  Fever  (Q.  658)      . 

9.  Cholera  (Q.  659)      . 

10.  Bubonic  Plague  (Q.  660) 

11.  Influenza  (Q.  661) 

12.  Pregnancy  (Q.  662  and  663) 

III.  Food  and  Beverages. 

1.  Tea  (Q.  664  to  666) 

2.  Coffee  (Q.  667) 

3.  Butter  (Q.  668  and  669) 

4.  Milk  (Q.  670  to  680) 

5.  Meat  (Q.  681) 

IV,  Alcohol  and  Tobacco. 

1.  Alcohol  (Q.  682  to  686) 

2.  Tobacco  (Q.  687  to  690) 
V.  Water  and  Ice. 

1.  Water  (Q.  691  to  716)       . 

2.  Ice  (Q.  717  to  721) 
VI.  Air  and  Ventilation  (Q.  722  to  726) 

VII.  Personal  Hygiene. 

1.  Bathing  (Q.  727  to  732) 

2.  Exercise  (Q.  733  to  740) 

3.  Clothing  (Q.  741  and  742) 
VIII.  Occupation  (Q.  743  to  750) 

IX.  Habitations  (Q.  751  to  769) 
X.  Schools  (Q.  770  to  787)      . 
XI.  Hospitals  (Q.  788  to  794) 
XII.  Disposal  of  Sewage  (Q.  795  to  810) 

XIII.  Disinfection  (Q.  811  to  828) 

XIV.  Vaccination  (Q.  829  to  835) 
XV.  Quarantine  (Q.  830  to  843) 

XVI.  Disposal  of  the  Dead  (Q.  844  to  846) 
XVII.  Vital  Statistics  (Q.  847  to  851)  . 

XVIII.  Miscellaneous  (Q.  852  to  870)    . 

Appendix. 

Questions  asked  January,  1903  (Q.  871  to  885) 
Questions  asked  May,  1903  (Q.  886  to  900)     . 
Questions  asked  June,  1903  (Q.  901  to  915)     . 
Questions  asked  September,  1903  (Q.  916  to  930) 
Questions  asked  January,  1904  (Q.  931  to  945) 
Questions  asked  May,  1904  (Q.  946  to  960)     . 
Questions  asked  June,  1904  (Q.  961  to  975)     . 
Questions  asked  September,  1904  (Q.  976  to  990) 


PAGE 

133 


PHYSIOLOGY  AND  HYGIENE. 


Works  to  which  the  References  in  the  Text  Apply. 

COLLINS  AND  ROCKWELL'S  PHYSIOLOGY. 
EGBERT'S  HYGIENE  AND  SANITATION.     Third  edition. 

Quotations  have  been  made  from  the  following  works: 

BACON'S  MAxVUAL  OF  OTOLOGY.     Third  edition. 

CHAPMAN'S  PHYSIOLOGY.     Second  edition. 

DUANE'S  MEDICAL  DICTIONARY. 

DUNGLISON'S  MEDICAL  DICTIONARY.    Twenty-third  edition 

GRAY'S  ANATO:\IY.     Fifteenth  edition. 

GUENTHER'S  EPITOME  OF  PHYSIOLOGY. 

HALL'S  TEXT-BOOK  OF  PHYSIOLOGY. 

HARE'S  PRACTICAL  THERAPEUTICS.    Tenth  edition. 

HARRINGTON'S  PRACTICAL  HYGIENE.     Second  edition. 

KING'S  ^L\NUAL  OF  OBSTETRICS.     Ninth  edition. 

SCHAFER'S  ESSENTIALS  OF  HISTOLOGY. 

SIMON'S  CLINICAL  DIAGNOSIS.    Fifth  edition. 

THOMPSON'S  PRACTICAL  MEDICINE.     Second  edition. 

The  following  ahhreviations  are  used  in  the  succeeding  pages: 

et  seq.  =  and  following  (page  or  pages). 
Q.  =  question. 
A.  =  answer. 


(17) 


PHYSIOLOGY  AND  HYGIENE. 


A.  PHYSIOLOGY. 
I.  THE  PHENOMENA  OF  LIFE. 

1.  Define  human  physiology.     {May,  1896.) 

2.  Define  human  physiology.     (May,  1899.) 

1  and  2.  Human  physiology  is  that  branch  of  science 
which  treats  of  the  functions  of  the  various  tissues  and 
organs  of  the  human  body  in  a  state  of  health. 

3.  Define  (a)  life  and  (b)  death.     {May,  1894.) 

3.  (a)  Life  has  been  defined  as  the  sum  of  the  properties 
that  enable  an  organism  to  adapt  itself  to  surrounding 
conditions.  In  Dunglison's  Medical  Dictionary,  Life  is 
defined  as  "the  state  of  organized  beings,  during  which, 
owing  to  the  union  of  an  unknown  force  with  matter, 
they  are  capable  of  performing  functions  different  from 
those  that  regulate  other  natural  bodies/'  (b)  Death  is 
^'the  complete  and  permanent  cessation  of  functional 
activity."    (Duane's  Medical  Dictionary.) 

4.  (a)  What  is  understood  hy  protoplasm  and  (b)  what 
are  its  physical  properties?    {January,  1896.) 

5.  (h)  What  are  the  physical  properties  of  protoplasm? 
{April,  1897.) 

6.  (b)  What  are  the  properties  of  protoplasm?  {May, 
1895.) 

7.  (b)  What  are  the  physiological  characteristics  of  proto- 
plasm?    {April,  1896.) 

8.  (b)  What  are  the  physiological  characteristics  of  proto- 
plasm?    {September,  1898.) 

(18) 


19  PHYSIOLOGY  AND  HYGIENE. 

9.  (c)  Of  ivhat  forms  of  activity  is  primary  tissue  capable? 
Illustrate.     (June,  1901.) 

4  to  9.  (a)  Collins  and  Rockwell's  Physiology,  page  22; 
(b)  pages  22  and  23;  (c)  pages  22  and  23. 

10.  Describe  an  amoeba.     {January,  1894.) 

10.  Collins  and  Rockwell's  Physiology,  pages  22  and  23. 

11.  (a)  Define  physiologically  the  term  cell,  (b)  Hoiu 
are  cells  reproduced?    {April,  1899.) 

12.  (b)  How  are  cells  reproduced?    {November,  1894.) 

13.  (c)  Illustrate  by  diagram  or  otherwise  the  structure 
of  a  cell.     {May,  1902.) 

14.  (d)  Describe  cell  growth.     {September,  1896.) 

15.  (d)  Describe  cell  growth.     {September,  1898.) 

16.  Describe  (c)  the  structure  and  (d)  the  growth  of  cells. 
{May,  1897.) 

17.  (d)  Describe  the  growth  and  assimilation  of  cells. 
{May,  1896.) 

18.  (e)  Mention  and  describe  three  varieties  of  cells 
according  to  shape.     {January,  1900.) 

19.  (f)  Mention  three  varieties  of  cells  according  to 
situation  in  the  body.     {September,  1899.) 

20.  (g)  How  are  cells  connected?     {September,  1895.) 

21.  (h)  Describe  the  decay  and  death  of  cells.  {May 
1895.) 

11  to  21.  (a)  Collins  and  Rockwell's  Physiology,  page 
19;  (b)  pages  20  and  21;  (c)  see  Fig.  1;  and  Collins  and 
Rockwell's  Physiology,  pages  18  to  20;  (d)  pages  20  and 
21.  (e)  '^From  their  shape,  cells  are  called  spherical  or 
spheroidal,  which  is  the  typical  shape  of  the  free  cell;  this 
may  be  altered  to  polyhedral  when  the  pressure  on  the 
cells  in  all  directions  is  nearly  the  same ;  of  this  the  primi- 
tive segmentation  cells  afford  an  example.  The  discoid 
form  is  seen  in  blood  corpuscles,  and  the  scale-like  form 
in  superficial  epithelial  cells."  (Kirkes'  Physiology.)  (f) 
Collins  and  Rockwell's  Physiology,  pages  23  and  24;  (g) 


20 


PHYSIOLOGY  AND  HYGIENE. 


cells  are  connected  (1)  by  the  anastomosing  of  their  pro- 
toplasmic processes,  and  (2)  by  intercellular  substance, 
which  cements  them  together;  (h)  Collins  and  Rockwell's 
Physiology,  page  21. 

Attraction  sphere  enclosing  the  centrosomea. 


■     r-,^*'"--i  •...-»  -j^. 


f  Plasmosome  or 
trueJ;nucleolus. 

Chromatin- 
-  network. 

3     Linin-network. 

Karyosonie  or 
net-knot. 


Plastids  lying^ 
in  the  cyto- 
plasm. 


>'C  0-'  >-/^ 


i..\uy--'y*. 


.Vacuole. 


Lifeless  bodies 
(metaplasm) 
suspended  in 
the  cytoplas- 
mic reticulum. 


Fig.  1. — Diagram  of  a  cell.     (After  Wilson.) 

^2.  Describe  the  development  of  the  nuclei  of  cells.  (June^ 
1893.) 

22.  Collins  and  Rockwell's  Physiology,  page  20. 

23.  What  is  metaholismf     {January,  1899.) 

23.  Collins  and  Rockwell's  Physiology,  page  18. 

II.  THE  STRUCTURE  OF  THE  ELEMENTARY  TISSUES. 
1.  Epithelial  Tissues. 

24.  (a)  Describe  epithelium,  (b)  Mention  varieties  of 
epithelium,  (c)  State  the  function  of  epithelium.  {June, 
1900.) 


21  .       PHYSIOLOGY  AND  HYGIENE. 

25.  Describe  epithelium  as  to  (d)  origin,  (e)  shape,  (f) 
location,  (c)  function.     (September,  1901.) 

26.  (c)  What  are  the  functions  of  epithelium?  {January, 
1898.) 

24  to  26.  (a)  Collins  and  Rockwell's  Physiology,  page 
23;  (b)  page  23;  (c)  page  24;  (d)  epithelium  originates 
from  the  epiblast  or  hypoblast;  endothelium  from  the 
mesoblast;  (e)  Collins  and  RockwelFs  Physiology,  page  23; 
(f)  pages  23  and  24;  and  see  Q.  886. 

27.  Name,  locate,  and  give  the  function  of  each  of  the 
varieties  of  epithelia.     {September,  1896.) 

28.  Give  the  principal  location  of  the  different  varieties  of 
epithelium.     {April,  1899.) 

29.  Give  the  functions  and  locality  of  each  of  the  different 
varieties  of  epithelia.     {November,  1893.) 

27  to  29.  Collins  and  RockwelFs  Physiology,  pages  23 
and  24. 

30.  (a)  Describe  ciliated  epithelium  and  (b)  state  where 
it  is  found  most  abundantly,  (c)  What  is  the  function  of 
ciliated  epithelium?    {April,  1898.) 

30.  (a)  Collins  and  Rockwell's  Physiology,  page  24. 
(b)  ^'The  situations  in  which  ciliated  epithelium  is  found 
in  the  human  body  are :  the  respiratory  tract  from  the  nose 
downward  to  the  smallest  ramifications  of  the  bronchial 
tube  (except  a  part  of  the  pharynx  and  the  surfgtce  of  the 
vocal  cords),  the  tympanum  and  Eustachian  tube,  the 
Fallopian  tube  and  upper  portion  of  the  uterus,  the  vasa 
efferentia,  coni  vasculosi,  and  the  first  part  of  the  excretory 
duct  of  the  testicle,  and  the  ventricles  of  the  brain  and 
central  canal  of  the  spinal  cord.''  (Gray's  Anatomy.)  (c) 
Motion  and  protection. 

31.  (a)  Describe  ciliary  motion]  (b)  describe  protoplasmic 
movement.     {April,  1895.) 

31.  (a)  ''When  Hving  ciliated  epithelium  is  examined 
under  the  microscope,  the  cilia  are  seen  to  be  in  constant 


22  PHYSIOLOGY  AND  HYGIENE, 

rapid  motion,  each  cilium  being  fixed  at  one  end,  and 
swinging  or  lashing  to  and  fro.  The  general  impression 
given  to  the  eye  of  the  observer  is  very  similar  to  that 
produced  by  waves  in  a  field  of  corn,  or  swiftly  running 
and  rippling  water,  and  the  result  of  their  movement  is  to 
produce  a  continuous  current  in  a  definite  direction,  and 
this  direction  is  invariably  the  same  on  the  same  surface, 
being  always,  in  the  case  of  a  cavity,  toward  its  external 
orifice/'  (Kirkes'  Physiology.)  (b)  Collins  and  Rockwell's 
Physiology,  page  22. 

2.  Connective  Tissues. 

32.  Define  connective  tissue.    Mention  and  describe  the 
different  varieties  of  connective  tissue.    (May,  1897.) 

33.  What  is  the  function  of  connective  tissue?  {June,  1898.) 
32  and  33.  ''  Connective  tissues  are  a  group  of  tissues 

forming  the  skeleton  with  its  various  connections — bones, 
cartilages,  and  ligaments — and  affording  a  supporting 
framework  and  investment  to  the  various  organs  com- 
posed of  nervous,  muscular,  and  glandular  tissues.  They 
are  classified  as  follows  (Kirkes): 

I.  The  Fibrous  Connective  Tissues. 

1.  Chief  Forms. 

White  fibrous  tissue. 
Elastic  tissue, 
Areolar  tissue. 

2.  Special  Varieties. 

Gelatinous  tissue. 

Adenoid  or  retiform  tissue. 

Neuroglia, 

Adipose  tissue. 
11.  Cartilage. 
III.  Bone. 
All  the  varieties  of  connective  tissue  are  made  up  of  two 
elements — cells  and  intercellular  substance.''     (Dunglison's 
Medical   Dictionary.)      And   see    Collins   and   Rockwell's 
Physiology,  page  24. 


23  PHYSIOLOGY  AND  HYGIENE. 

34'  Differentiate  white  fibrous  tissue  and  yellow  elastic 
tissue  as  to  (1)  structure,  and  (2)  distribution.    {May,  1898.) 

34.  '^The  white  fibrous  tissue  is  a  true  connecting 
structure,  and  serves  three  purposes  in  the  animal  economy. 
In  the  form  of  Hgaments  it  serves  to  bind  bones  together; 
in  the  form  of  tendons  it  serves  to  connect  muscles  to 
bones  or  other  structures,  and  it  forms  an  investing  or 
protecting  structure  to  various  organs  in  the  form  of 
membranes.  Examples  of  where  it  serves  this  latter 
office  are  to  be  found  in  the  muscular  fascise  or  sheaths, 
the  periosteum,  and  perichondrium;  the  investments  of 
the  various  glands  (such  as  the  tunica  albuginea  testis, 
the  capsule  of  the  kidney,  etc.),  the  investing  sheath  of 
the  nerves  (epineurium),  and  of  various  organs,  as  the 
penis  and  the  eye  (sheath  of  the  corpora  cavernosa  and 
•corpus  spongiosum,  and  of  the  sclerotic).  In  white  fibrous 
tissue,  as  its  name  implies,  the  white  fibres  predominate, 
the  matrix  being  apparent  only  as  a  cement-substance, 
the  yellow  elastic  fibres  comparatively  few,  while  the 
tissue  cells  are  arranged  in  a  special  manner.  It  presents 
to  the  naked  eye  the  appearance  of  silvery-white,  glistening 
fibres,  covered  over  with  a  quantity  of  loose,  flocculent 
tissue  which  binds  the  fibres  together  and  carries  the 
bloodvessels.  It  is  not  possessed  of  any  elasticity,  and 
only  the  very  slightest  extensibility;  it  is  exceedingly 
strong,  so  that  upon  the  application  of  any  external 
violence  the  bone  with  which  it  is  connected  will  fracture 
before  the  fibrous  tissue  will  give  way.  In  ligaments  and 
tendons  the  bundles  run  parallel  with  each  other;  in 
membranes  they  intersect  one  another  in  different  places. 
The  cells  occurring  in  white  fibrous  tissue  are  often  called 
Hendon  cells.'  They  are  situated  on  the  surface  of 
groups  of  bundles  and  are  quadrangular  in  shape,  arranged 
in  rows  in  single  file,  each  cell  being  separated  from  its 
neighbors  by  a  narrow  line  of  cement-substance.  The 
nucleus  is  generally  situated  at  one  end. 

"Yelhw  Elastic  Tissue. — In  certain  parts  of  the  body 


24  '  PHYSIOLOGY  AND  HYGIENE, 

a  tissue  is  found  which  when  viewed  in  mass  is  of  a  yellowish 
color,  and  is  possessed  of  great  elasticity,  so  that  it  is 
capable  of  considerable  extension,  and  when  the  extending 
force  is  withdrawn  returns  at  once  to  its  original  con- 
dition. This  is  yellow  elastic  tissue,  w^hich  may  be  regarded 
as  a  connective  tissue  in  which  the  yellow  elastic  fibres 
have  developed  to  the  practical  exclusion  of  the  other 
elements.  It  is  found  in  the  ligament  a  subflava,  in  the 
vocal  cords,  in  the  longitudinal  coat  of  the  trachea  and 
bronchi,  in  the  inner  coats  of  the  bloodvessels,  especially 
the  larger  arteries,  and  to  a  very  considerable  extent  in 
the  thyrohyoid,  cricothyroid,  and  stylohyoid  ligaments. 
It  is  also  found  in  the  ligamentum  nuchse  of  the  lower 
animals.  In  some  parts,  where  the  fibres  are  broad  and 
large  and  the  network  close,  the  tissue  presents  the  appear- 
ance of  a  membrane,  with  gaps  or  perforations  correspond- 
ing to  the  intervening  space.  This  is  to  be  found  in  the 
inner  coat  of  the  arteries,  and  to  it  the  name  of  fenestrated 
membrane  has  been  given  by  Henle.''    (Gray's  Anatomy.) 

35.  (a)  How  is  adipose  tissue  developed?  (b)  What  is 
its  use?     (May,  1899.) 

36.  (b)  Mention  the  chief  uses  of  adipose  tissue.  (Sep- 
tember, 1902.) 

37.  (a)  How  are  fat-cells  developed?    (January,  1898.) 

38.  (c)  Where  is  fat  stored  in  the  body?  (b)  State  the 
uses  of  fat.     (September,  1899.) 

35  to  38.  (a)  '^Adipose  tissue  consists  of  small  vesicles, 
fat-cells,  lodged  in  the  meshes  of  areolar  tissue.  The  fat- 
cells  vary  in  size,  but  of  about  the  average  diameter  of  g-g-g- 
of  an  inch.  They  are  formed  of  an  exceedingly  delicate 
protoplasmic  membrane,  filled  with  fatty  matter,  which 
is  liquid  during  life,  but  becomes  solidified  after  death. 
They  are  round  or  spherical  where  they  have  not  been 
subjected  to  pressure;  otherwise  they  assume  a  more  or 
less  angular  outline.  These  fat-cells  are  contained  in 
clusters  in  the  areolae  of  fine  connective  tissue,  and  are 


25  PHYSIOLOGY  AND  HYGIENE. 

held  together  mainly  by  a  network  of  capillary  blood- 
vessels which  are  distributed  to  them.  The  fat-cells  are 
formed  by  the  transformation  of  connective-tissue  cor- 
puscles, in  which  small  droplets  of  oil  are  formed;  these 
coalesce  to  produce  a  larger  drop,  and  this  increases  until 
it  distends  the  corpuscle,  the  remaining  protoplasm  and 
the  nucleus  being  crowded  to  the  periphery  of  the  cell.'' 
(Gray's  Anatomy.)  (b)  To  maintain  the  heat  of  the  body 
by  preventing  its  too  rapid  dissipation,  as  a  packing 
material,  as  a  protective,  as  a  support  for  the  small  blood- 
vessels in  the  long  bones,  and  to  give  form  and  roundness 
to  the  body,  (c)  Fat  is  chiefly  found  in  the  subcutaneous 
areolar  tissue  ancj  under  serous  membranes;  especially 
around  the  kidneys,  in  the  omentum  and  mesentery,  and 
around  the  heart. 

39.  (a)  Give  the  varieties  of  cartilage,  and  (b)  state  their 
general  distribution.     (May,  1898.) 

Jfi.  (a)  In  how  many  forms  does  cartilage  exist?  (c) 
What  are  the  functions  of  cartilage?    (September,  1898.) 

41.  (d)  Describe  the  physical  characteristics  of  cartilage. 
(e)  What  is  temporary  cartilage,  permanent  cartilage? 
Illustrate.     {April,  1899.) 

Jj.2,  How  is  cartilage  (f)  developed,  (g)  nourished?  {June, 
1897.) 

43.  (g)  How  is  cartilage  nourished?  (c)  Mention  the 
functions  of  cartilage.     {January,  1900.) 

39  to  43.  (a)  The  varieties  of  cartilage  are  (1)  hyaline, 
in  which  the  matrix  is  almost  clear  and  has  no  fibres;  (2) 
fibrocartilage,  in  which  the  matrix  has  connective-tissue 
fibres — and  see  (b) .  (b)  Hyaline  cartilage  is  found  covering 
the  articular  ends  of  the  bones,  where  it  is  called  articular 
cartilage;  forming  the  cartilages  of  the  ribs,  where  it  is 
called  costal  cartilage;  also  in  the  trachea,  larynx,  nose, 
and  external  auditory  meatus.  Fibrocartilage  is  of  two 
varieties:  (1)  the  yellow  or  elastic,  which  is  found  in  the 
epiglottis,  the  cartilages  of  Santorini  (in  the  larynx),  the 


26  PHYSIOLOGY  AND  HYGIENE. 

external  ear,  the  Eustachian  tube;  and  (2)  the  white  fibro- 
cartilage,  which  is  found  in  the  intervertebral  disks, 
symphysis  pubis,  surrounding  the  margin  of  some  articular 
cavities,  as  the  glenoid  cavity  of  the  shoulder,  and  the 
cotyloid  cavity  of  the  hip,  and  occasionally  in  the  tendons 
of  some  muscles,  (c)  '^  Cartilage  not  only  represents  in 
the  foetus  the  bones  which  are  to  be  formed  (temporary 
cartilage),  but  also  offers  a  firm,  yet  more  or  less  yielding, 
framework  for  certain  parts  in  the  developed  body,  possess- 
ing at  the  same  time  strength  and  elasticity.  It  maintains 
the  shape  of  tubes,  as  in  the  larynx  and  trachea.  It  affords 
attachment  to  muscles  and  ligaments;  it  binds  bones 
together,  yet  allows  a  certain  degree  of  movement,  as 
between  the  vertebrae;  it  forms  a  firm  framework  and 
protection,  yet  without  undue  stiffness  or  weight,  as  in  the 
pinna,  larynx,  and  chest  walls;  it  deepens  joint  cavities, 
as  in  the  acetabulum,  without  unduly  restricting  the  move- 
ments of  the  bones."  (Kirkes'  Physiology.)  (d)  -Hyaline 
cartilage  is  a  firm,  elastic,  translucent  substance,  bluish- 
white  in  color,  and  consists  of  cells  and  intercellular 
substance;  the  intercellular  substance  may  be  granular 
or  homogeneous;  the  cells  are  oval  or  spheroidal,  with 
flattened  sides,  and  are  unevenly  distributed  in  the  base- 
ment membrane,  generally  lying  in  groups  of  two  or  four. 
In  white  fibrocartilage  the  intercellular  substance  is 
fibrillated.  In  the  yellow  or  elastic  variety  the  basement 
membrane  is  granular,  yellowish,  and  opaque ;  and  the  cells 
are  surrounded  by  a  capsule,  consisting  of  a  refractile 
substance,  (e)  ^^In  the  foetus  at  an  early  period  the 
greater  part  of  the  skeleton  is  cartilaginous.  As  this  carti- 
lage is  afterward  replaced  by  bone,  it  is  called  temporary, 
in  contradistinction  to  that  which  remains  unossified  during 
the  whole  of  life,  and  which  is  called  permanent.^'  (Gray's 
Anatomy.)  (f)  '^  Cartilage  is  developed  out  of  an  embryonal 
tissue,  consisting  of  cells  with  a  very  small  quantity  of 
intercellular  substance ;  the  cells  multiply  by  fission  within 
the   cell-capsules,   while   the   capsule   of  the  parent  cell 


27  PHYSIOLOGY  AND  HYGIENE. 

becomes  gradually  fused  with  the  surrounding  intercellular 
substance.  A  repetition  of  this  process  in  the  young  cells 
causes  a  rapid  growth  of  the  cartilage  by  the  miitiplication 
of  its  cellular  elements  and  corresponding  increase  in  its 
matrix.  Thus  we  see  that  the  matrix  of  cartilage  is  chiefly 
derived  from  the  cartilage  cells."  (Kirkes'  Physiology.) 
(g)  '' Hyaline  cartilage  is  reckoned  among  the  so-called 
non-vascular  structures,  no  bloodvessels  being  supplied 
directly  to  its  ow^n  substance;  it  is  nourished  by  those  of 
the  bone  beneath.  When  hyaline  cartilage  is  in  thicker 
masses,  as  in  the  case  of  the  cartilages  of  the  ribs,  a  few 
bloodvessels  traverse  its  substance."    (Kirkes'  Physiology.) 

44'  (a)  Hoio  is  hone  nourished?  (b)  How  is  cartilage 
nourished?    (January,  1902.) 

45.  (a)  How  are  hones  nourished?    (September,  1893.) 

46.  (a)  How  is  hone  nourished?  (c)  Give  an  example  of 
the  development  of  hone.     (April,  1898.) 

47.  (d)  Describe  the  development  of  hone  from  cartilage. 
(September,  1900.) 

48.  (e)  Give  the  process  of  development  of  the  parietal 
bone.     (January,  1895.) 

4:4:  to  48.  (a)  ^'The  bloodvessels  of  bone  are  very 
numerous.  Those  of  the  compact  tissue  are  derived  from 
a  close  and  dense  network  of  vessels  ramifying  in  the 
periosteum.  From  this  membrane  vessels  pass  into  the 
minute  orifices  in  the  compact  tissue,  running  through  the 
canals  which  traverse  its  substance.  The  cancellous  tissue 
is  supplied  in  a  similar  way,  but  by  a  less  mmierous  set  of 
larger  vessels,  which,  perforating  the  outer  compact  tissue, 
are  distributed  to  the  cavities  of  the  spongy  portion  of  the 
bone.  In  the  long  bones  numerous  apertures  may  be  seen 
at  the  ends  near  the  articular  surfaces,  some  of  which  give 
passage  to  the  arteries  of  the  larger  set  of  vessels  referred 
to;  but  the  most  munerous  and  largest  apertures  are  for 
the  veins  of  the  cancellous  tissue,  which  run  separately 
from  the  arteries.     The  medullary  canal  in  the  shafts  of 


28  PHYSIOLOGY  AND  HYGIENE. 

the  long  bones  is  supplied  by  one  large  artery  (or  some- 
times more),  which  enters  the  bone  at  the  nutrient  foramen 
(situated  in  most  cases  near  the  centre  of  the  shaft)  and 
perforates  obliquely  the  compact  structure.  The  medullary 
or  nutrient  artery,  usually  accompanied  by  one  or  two 
veins,  sends  branches  upward  and  downward  to  supply 
the  medullary  membrane,  which  lines  the  central  cavity 
and  the  adjoining  canals.  The  ramifications  of  this  vessel 
anastomose  with  the  arteries  both  of  the  cancellous  and 
compact  tissues.  In  most  of  the  flat  and  in  many  of  the 
short  spongy  bones  one  or  more  large  apertures  are 
observed,  which  transmit,  to  the  central  parts  of  the  bone, 
vessels  corresponding  to  the  medullary  arteries  and  veins. 
The  veins  emerge  from  the  long  bones  in  three  places 
(Kolliker) :  (1)  by  one  or  two  large  veins,  which  accompany 
the  artery;  (2)  by  numerous  large  and  small  veins  at  the 
articular  extremities;  (3)  by  many  small  veins  which  arise 
in  the  compact  substance.  In  the  flat  cranial  bones  the 
veins  are  large,  very  numerous,  and  run  in  tortuous  canals 
in  the  diploic  tissue,  the  sides  of  the  canals  being  formed 
by  a  thin  lamella  of  bone,  perforated  here  and  there  for 
the  passage  of  branches  from  the  adjacent  cancelli.  The 
same  condition  is  also  found  in  all  cancellous  tissue,  the 
veins  being  enclosed  and  supported  by  osseous  structure 
and  having  exceedingly  thin  coats. ^'  (Gray\s  Anatomy.) 
(b)  See  Q.  39  to  43  (g).  (c)  ''True  bone  is  essentially 
formed  in  all  cases  by  an  ossification  of  connective  tissue. 
Sometimes  the  bone  is  preceded  by  cartilage,  which  first 
becomes  calcified,  and  this  is  then  invaded,  and  for  the 
most  part  removed,  by  an  embryonic  tissue  which  re- 
deposits  bony  matter  in  the  interior  of  the  cartilage,  while 
at  the  same  time  layers  of  bone  are  being  formed  outside 
underneath  the  periosteum.  This  is  intracartilaginous  or 
endochondral  ossification.  Sometimes  the  bone  is  not  pre- 
ceded by  cartilage,  and  then  the  only  process  which  occurs 
is  one  corresponding  to  the  subperiosteal  ossification  of  the 
former  variety ;  the  ossification  is  then  known  as  intramem- 


29  PHYSIOLOGY  AND  HYGIENE. 

branous."  (Schafer's  Histology.)  (d)  ''Ossification  of  carti- 
lage. This  may  be  described  as  occurring  in  three  stages.  In 
the  first  stage  the  cells  in  the  middle  of  the  cartilage  become 
enlarged  and  arranged  in  rows  radiating  from  the  centre, 
and  fine  granules  of  calcareous  matter  are  deposited  in  the 
matrix.  Simultaneously  with  this  the  osteoblasts  under- 
neath the  periosteum  deposit  a  layer  or  layers  of  fibrous 
lamellae  upon  the  surface  of  the  cartilage,  and  these  lamellae 
also  become  calcified.  As  they  are  formed,  some  of  the 
osteoblasts  are  included  between  them  and  become  bone 
corpuscles.  In  the  second  stage  some  of  the  subperiosteal 
tissue  eats  its  way  through  the  newly  formed  layer  of  bone 
and  into  the  centre  of  the  calcified  cartilage.  This  is  freely 
absorbed  before  it,  so  that  large  spaces  are  produced  which 
are  filled  with  osteoblasts  and  contain  numerous  blood- 
vessels which  have  grown  in  at  the  same  time.  The  spaces 
are  termed  medullary  spaces,  and  this  second  stage  may  be 
termed  the  stage  of  irruption.  In  the  third  stage  of  endo- 
chondral ossification  there  is  a  gradual  advance  of  the 
ossification  toward  the  extremities  of  the  cartilage,  and  at 
the  same  time  a  gradual  deposition  of  fresh  bony  lamellae 
and  spicules  on  the  walls  of  the  medullary  spaces,  and  on 
the  surface  of  the  new  bone  under  the  periosteum.  The 
advance  into  the  cartilage  always  takes  place  by  a  repetition 
of  the  same  changes,  the  cartilage  cells  first  enlarging  and 
becoming  arranged  in  rows,  the  matrix  between  the  rows 
becoming  calcified,  and  then  the  calcified  cartilage  becom- 
ing excavated  from  behind  by  the  osteoblastic  tissue  so 
as  to  form  new  medullary  spaces.  The  walls  of  these  are 
at  first  formed  only  by  remains  of  the  calcified  cartilage 
matrix,  but  they  soon  become  thickened  by  lamellae  of 
fibrous  bone  which  are  deposited  by  the  osteoblasts,  and 
between  which  bone  corpuscles  become  included,  as  in  the 
case  of  the  subperiosteal  bone.  The  latter  advances  pari 
passu  with  the  endochondral  calcification,  but  beyond  this 
the  uncalcified  cartilage  grows  both  in  length  and  breadth, 
so  that  the  ossification  is  always  advancing  into  larger 


30  PHYSIOLOGY  AND  HYGIENE. 

portions  of  cartilage;  hence  the  endochondral  bone,  as  it 
forms,  assumes  the  shape  of  an  hour-glass,  the  cylindrical 
shape  of  the  whole  bone  being  maintained  by  additions 
of  periosteal  bone  to  the  outside.  The  absorption  of  the 
calcified  cartilage  matrix  appears  to  be  effected,  as  is  the 
case  with  absorption  of  bony  matter  wherever  it  occurs, 
by  large  multinucleated  cells  which  are  termed  osteoclasts. 
They  are  cells  of  the  same  nature  as  the  myeloplaxes  of 
the  marrow,  and  are  found  on  surfaces  where  absorption 
of  bone  is  taking  place,  whereas  the  osteoblasts  are  always 
foimd  covering  surfaces  where  bony  deposit  is  proceeding. 
The  bone  which  is  first  formed  is  more  reticular  and  less 
regularly  lamellar  than  that  of  the  adult,  and  contains  no 
Haversian  systems.  The  regular  lamellae  are  not  deposited 
until  some  little  time  after  birth,  and  their  deposition  is 
generally  preceded  by  a  considerable  amount  of  absorption. 
It  is  about  this  time  also  that  the  medullary  canal  of  the 
long  bones  is  formed  by  the  absorption  of  the  bony  tissue 
which  originally  occupies  the  centre  of  the  shaft.  After 
a  time  the  cartilage  in  one  or  both  ends  of  the  long  bones 
begins  to  ossify  independently,  and  the  epiphyses  are 
formed.  These  are  not  joined  to  the  shaft  until  the  growth 
of  the  bone  is  completed.  Growth  takes  place  in  length 
by  an  expansion  of  the  cartilage  (intermediate  cartilage) 
which  intervenes  between  the  shaft  and  the  epiphyses,  and 
by  the  gradual  extension  of  the  ossification  into  it ;  in  width 
entirely  by  the  deposition  of  fresh  bony  layers  under  the 
periosteum.  In  the  terminal  phalanges  of  the  digits  the 
ossification  starts,  not  from  the  middle  of  the  cartilage, 
but  from  its  distal  extremity.  For  the  regeneration  of 
portions  of  bone  which  have  been  removed  by  disease  or 
operation  it  is  important  that  the  periosteum  be  left." 
(Schafer's  Histology.)  (e)  ' '  Intramembranous  ossification. 
In  this  variety  of  ossification  the  bone  is  not  preceded  by 
cartilage  at  all,  and  therefore  no  endochondral  bone  is 
formed,  but  the  calcification  occurs  in  a  sort  of  embryonic 
fibrous  tissue  which  contains  numerous  osteoblasts  and 


31  PHYSIOLOGY  AND  HYGIENE. 

bloodvessels.  The  fibres  of  this  tissue  (osteogenic  fibres), 
which,  like  those  of  fibrous  tissue,  are  collected  into  small 
bundles,  become  enclosed  in  a  calcareous  matrix,  produced 
by  the  deposition  of  lime  salts  in  the  ground-substance  of 
the  connective  tissue,  and  as  the  fibres  grow  the  calcifica- 
tion extends  further  and  further,  so  that  bony  spicules  are 
formed,  which,  as  they  become  thickened,  rim  together  to 
form  reticular  layers,  leaving  spaces  filled  with  osteoblasts 
arotmd  the  bloodvessels.  The  osteogenic  fibres  are  covered 
with  osteoblasts,  and  as  the  bone  forms  some  of  these  be- 
come left  as  bone  corpuscles  within  lacunae.  Thus,  in  every 
particular  the  development  of  these  bones  resembles  that 
of  the  subperiosteal  layer  of  endochondral  bone,  which  is 
also  to  be  considered  as  an  instance  of  intramembranous 
ossification,  although  taking  place  on  the  surface  of 
cartilage.  Moreover,  it  is  the  same  subperiosteal  tissue 
which,  in  endochondral  ossification,  deposits  the  true  or  * 
secondary  bone  upon  those  parts  of  the  calcified  cartilage 
matrix  which  have  escaped  absorption;  and  this  must  also, 
therefore,  be  reckoned  as  developed  according  to  the  same 
type.  In  fact,  even  in  intracartilaginous  ossification,  very 
little  of  the  calcified  cartilage  matrix  eventually  remains; 
this  being  almost  wholly  absorbed  and  either  replaced  by 
true  or  fibrous  bone  which  has  been  formed  by  osteoblasts, 
or  swept  away  to  form  the  medullary  and  other  cavities. '^ 
(Schafer's  Histology.) 

3.  The  Teeth. 

49.  (a)  Give  the  number  and  arrangement  of  the  temporary 
or  milk  teeth.    {January,  1898.) 

50.  (a)  State  the  approximate  time  of  eruption  of  the 
temporary  teeth.     {April,  1894.) 

51 .  (b)  Give  the  number  and  arrangement  of  the  permanent 
set  of  teeth,  (c)  State  the  particular  use  of  each  kind  of  teeth. 
{January,  1902.) 

52.  (d)  Describe  the  growth  and  the  development  of  the 
teeth.     {January,  1899.) 


32 


PHYSIOLOGY  AND  HYGIENE. 


"53.  (e)  Give  the  process  of  replacement  of  temporary  hy 
permanent'lteeth.     (April,  1895.) 

^54.  (f)  Describe  the  temporary  and  the  permanent  teeth. 
(June,  1899.) 
49  to  54.  (a) 


(b) 


Molan 


Canine 


Fig.  2. — Temporary  teeth.     (Time  given  in  months.) 


Molars 


Bicuspids 


Canine 


Fig.  3. — Permanent  teeth     (Time  given  in  years.) 


33  PHYSIOLOGY  AND  HYGIENE. 

(c)  The  incisors  are  to  hold  and  divide  the  food  as  it  is 
taken  into  the  mouth;  the  canines  also  divide  the  food; 
the  bicuspids  and  molars  triturate  the  food,  the  molars 
particularly  being  the  teeth  used  in  mastication,  (d) 
''The  teeth  are  developed  in  the  same  manner  as  the 
hairs.  A  continuous  thickening  of  the  epithelium  occurs 
along  the  line  of  the  gums  and  grows  into  the  corium  of 
the  mucous  membrane  {common  dental  germ,  or  dental 
lamina).  At  regular  intervals  there  is  yet  a  further  thick- 
ening and  growth  from  the  common  germ  into  the  tissue 
of  the  mucous  membrane,  each  of  these  special  rudiments, 
which  are  ten  in  number,  swelling  out  below  into  a  flask- 
shaped  mass  of  cells,  the  special  dental  germ  of  a  milk 
tooth.  The  intermediate  parts  of  the  dental  lamina  long 
remain,  forming  a  common  epithelial  strand  uniting  the 
several  special  dental  germs  to  one  another  and  to  the 
epithelium  covering  the  gum.  A  vascular  papilla  is  con- 
tinued from  the  corium  into  the  bottom  of  each  special 
germ ;  this  papilla  has  the  shape  of  the  crown  of  the  future 
tooth.  Each  special  dental  germ,  with  its  included  papilla, 
presently  becomes  almost  entirely  cut  off  from  the  epithe- 
lium of  the  mouth,  and  surrounded  by  a  vascular  mem- 
brane— the  dental  sac.  The  papilla  becomes  transformed 
into  the  dentine  and  pulp  of  the  future  tooth,  and  the 
enamel  is  deposited  upon  its  surface  by  the  epithelial  cells 
of  the  dental  germ.  The  root  of  the  tooth,  with  its  covering 
of  cement,  is  formed  at  a  later  period,  when  the  tooth  is 
beginning  to  grow  up  through  the  gum  by  a  gradual 
elongation  of  the  base  of  the  papilla.  The  shaping  of  this 
into  the  form  of  the  root  is  determined  by  a  growth  of 
the  epithelium  of  the  dental  germ,  which  extends  in  the 
form  of  a  fold  (the  epithelium  sheath  of  v.  Brimn)  towards 
the  future  apex  of  each  fang.  Previously  to  the  deposition 
of  the  enamel,  the  dental  germ  undergoes  a  peculiar  trans- 
formation of  its  previously  polyhedral  epitheHum  cells  into 
three  layers  of  modified  cells.  One  of  these  is  a  layer  of 
columnar  cells  (adamantohlasts,  or  amelohlasts) ,  immediately 


34  PHYSIOLOGY  AND  HYGIENE. 

covering  the  surface  of  the  dentine.  These  columnar  cells 
form  the  enamel  prisms  by  a  fibrous  formation,  followed 
by  a  deposition  of  calcareous  salts  external  to  the  cells 
(or,  as  some  hold,  by  a  direct  calcification  of  their  proto- 
plasm). The  cells  next  to  the  dental  sac  form  a  single 
layer  of  cubical  epithelium  and  nearly  all  the  other  cells 
of  the  dental  germ  become  transformed  into  branching 
corpuscles  commimicating  by  their  processes,  and  thus 
forming  a  continuous  network.  This  part  of  the  dental 
germ,  after  it  is  thus  modified,  is  known  as  the  enamel 
organ.  The  dentine  of  the  tooth  is  formed  by  calcification 
of  the  surface  of  the  papilla.  At  this  surface  there  is  a 
well-marked  layer  of  odontoblasts,  and  these  produce  a 
layer  of  dentinal  matrix  which  forms  a  sort  of  cap  to  the 
papilla,  and  which  soon  becomes  calcified  by  the  deposition 
of  globules  of  calcareous  matter.  Processes  of  the  odonto- 
blasts remain  in  the  dentine  as  it  is  forming,  and  thus  the 
dentinal  tubules  are  produced.  Subsequently  other  layers 
of  dentine  are  formed  within  the  first  by  a  repetition  of 
the  same  process,  and  in  this  way  the  papilla  gradually 
becomes  calcified.  A  part,  however,  remains  unaltered  in 
the  centre  of  the  tooth,  and  with  its  covering  of  odonto- 
blasts forms  the  pulp.  The  ten  milk-teeth  are  formed  in 
each  jaw  in  this  manner.  These,  however,  become  lost 
within  a  few  years  after  birth,  and  are  replaced  by  perma- 
nent teeth  in  much  the  same  way  that  a  new  succession  of 
hairs  occurs.  A  small  outgrowth  takes  place  at  an  early 
period  from  the  dental  germ  of  each  of  the  milk-teeth,  and 
this  eventually  becomes  the  germ  of  the  corresponding 
permanent  tooth.  It  gradually  enlarges,  acquires  a  papilla, 
forms  an  enamel  organ;  in  short,  passes  through  the  same 
phases  of  development  as  its  parent  germ;  and, when  the 
milk-tooth  drops  out  of  the  jaw  in  consequence  of  the 
absorption  of  its  roots  (by  osteoclasts)  the  permanent  tooth 
grows  up  into  its  place.  But  there  are  six  permanent  teeth 
in  each  jaw  which  do  not  succeed  milk-teeth;  these  are  the 
permanent  molars.    They  are  developed  from  an  extension 


35  PHYSIOLOGY  AND  HYGIENE. 

(backwards  of  the  original  epithelial  thickening  or  common 
dental  germ  and  the  downgrowth  from  this  into  the  corium 
of  three  successive  special  germs  at  comparatively  long 
intervals  of  time.  Within  these  the  tissues  of  the  permanent 
molars  become  formed  in  a  manner  exactly  similar  to  that 
in  which  the  milk-teeth  are  develoyed/'  (Schafer's  His- 
tology.) (e)  '^  Previous  to  the  permanent  teeth  penetrating 
the  gum,  the  bony  partitions  which  separate  their  sacs 
from  the  deciduous  teeth  are  absorbed,  the  roots  of  the 
temporary  teeth  disappear  by  absorption  through  the 
agency  of  particular  multinucleated  cells,  called  odonto- 
blasts, which  are  developed  at  the  time  in  the  neighborhood 
of  the  root,  and  the  permanent  teeth  become  placed  under 
the  loose  crown  of  the  deciduous  teeth;  the  latter  finally 
become  detached,  and  the  permanent  teeth  take  their 
place  in  the  mouth. '^    (Gray's  Anatomy.)    (f)  See  (a)  to  (e). 

4.  Muscular  Tissues. 

55.  Describe  the  structure  of  (a)  striated  muscle,  (b)  non- 
striated  muscle,  (c)  Which  of  these  is  called  voluntary,  and 
why?     (January,  1901.) 

56.  (d)  Differentiate  voluntary  and  involuntary  muscles. 
Illustrate.     {June,  1898.) 

57.  (e)  What  are  the  functions  of  voluntary  muscles? 
{January,  1892.) 

58.  (f)  What  are  the  functions  of  involuntary  muscles f 
{January,  1892.) 

59.  (f)  Mention  the  uses  of  the  involuntary  muscles. 
{March,  1893.) 

60.  (g)  Name  some  of  the  involuntary  muscles  and  the 
functions  with  which  each  is  connected.     {September,  1892.) 

61.  (h)  What  are  the  varieties  of  muscular  tissue?  (i) 
What  peculiarity  distinguishes  the  muscular  fibres  of  the 
heart?     {September,  1901.) 

55  to  61.  (a)  Collins  and  Rockwell's  Physiology,  page 
143;  (b)  page  142;  (c)  -page  142;  (d)  pages  142  to  144; 


36  PHYSIOLOGY  AND  HYGIENE. 

(e)  motion  and  locomotion ;  (f )  motility  of  the  walls  of  the 
structures  in  which  they  are  found,  and  so  to  influence  the 
passage  of  material  through  these  structures;  (g)  involim- 
tary  muscle  is  found  in  the  oesophagus,  stomach,  intestines^ 
ureters,  bladder,  trachea,  bronchi,  gall-bladder,  ducts  of 
glands,  uterus,  Fallopian  tubes,  bloodvessels,  skin;  (h) 
CoUins  and  Rockwell's  Physiology,  page  142;  (i)  pages  142 
and  144. 

5.  Nervous  Tissues. 

62.  (a)  Describe   nerve  cells   and  nerve  tissue.      (June, 
1897.) 

63.  (b)  Describe  medullated  nerve  fibres.    (May^  1898.) 

64.  (b)  Describe  the  component  parts  of  a  medullated  nerve 
fibre.     (June,  1895.) 

62  to  64.  (a)  Collins  and  Rockwell's  Physiology,  pages 
162  and  159;  (b)  pages  159  and  160. 

III.  THE  CHEMICAL  COMPOSITION  OF  THE  BODY. 

65.  Name  the  inorganic  proximate  principles  that  enter 
into  the  formation  of  the  human  body.    {January,  1892.) 

65.  Collins  and  Rockwell's  Physiology,  page  26. 

IV.  THE  BLOOD  AND  CIRCULATION. 
1.  The  Blood. 

66.  What  is   the   composition   of   the   liquor  sanguinis? 
{April,  1893.) 

66.  See  A.  947  (a). 

67.  What  is  the  specific  gravity  of  human  blood?    {June, 
1893.) 

67.  Collins  and  Rockwell's  Physiology,  page  31. 

68.  Name  some  of  the  bodily  states  which  lessen  the  alka- 
linity of  the  blood.     {June,  1894.) 


37  PHYSIOLOGY  AND  HYGIENE. 

68.  ^^The  alkalinity  of  the  blood  may  be  decreased 
during  health  by  (1)  great  muscular  exertion,  and  (2)  by 
exposure  of  the  blood  to  the  conditions  of  coagulation. 
Pathologically,  the  alkalinity  of  the  blood  may  be  decreased 
by  (1)  anaemia,  (2)  uraemia,  (3)  rheumatism,  (4)  high  fever, 
(5)  diabetes,  (6)  cholera.'^    (HalFs  Text-hook  of  Physiology.) 

69.  (a)  Describe  human  hlood.  (b)  What  is  the  weight  of 
the  hlood  as  compared  with  the  weight  of  the  whole  hodyf 
(January,  1898.) 

70.  (b)  What  proportion  of  the  weight  of  the  body  is  hlood? 
(June,  1896.) 

71 .  (b)  How  does  the  total  weight  of  the  body  compare  with 
that  of  the  blood  in  the  human  system?    (April,  1895.) 

72.  (b)  What  proportion  does  the  weight  of  the  blood  hear 
to  the  weight  of  the  entire  body?  (c)  Give  the  use  of  the 
blood.     (September,  1900.) 

69  to  72.  (a)  Collins  and  Rockwell's  Physiology,  pages  30 
et  seq.;  (b)  page  32;  (c)  page  46. 

73.  (a)  Describe  the  coagulation  of  hlood.  (January, 
1892.) 

7J+.  (a)  Describe  the  coagulation  of  the  hlood.  (November, 
1894.) 

75.  (a)  Give  a  comprehensive  description  of  the  coagu- 
lation of  blood.     (May,  1895.) 

76.  (a)  Relate  the  steps  in  the  coagulation  of  hlood.  (Sep- 
tember, 1896.) 

77.  (b)  Give  the  cause  of  coagulation  of  hlood.  (c)  How 
long  after  death  does  blood  coagulate  in  the  body?  (Sep- 
tember, 1902.) 

78.  (d)  What  conditions  retard,  suspend,  or  prevent  the 
coagidation  of  blood?    (April,  1895.) 

79.  (d)  What  conditions  hasten  the  coagulation  of  hlood, 
and  what  means  may  he  adopted  to  retard  or  prevent  it? 
(September,  1897.) 

73  to  79.  (a)  Collins  and  Rockwell's  Physiology,  pages 
42  et  seq.;  (b)  pages  43  and  44 ;  (c)  after  death,  the  blood 


38  PHYSIOLOGY  AND  HYGIENE. 

coagulates  in  the  body  in    from  twelve  to  twenty-four 
hours;  (d)  Collins  and  Rockwell's  Physiology,  page  43. 

80.  Why  does  blood  remain  fluid  in  the  body  in  life  and 
coagulate  when  shed?    {May,  1896.) 

80.  Collins  and  RockwelFs  Physiology,  page  45. 

81.  (a)  Give  the  process  of  coagulation  of  hlood.  (b) 
Describe  a  white  blood  corpuscle.    (April,  1898.) 

81.  (a)  Collins  and  Rockwell's  Physiology,  pages  42  et 
seq.;  (b)  page  38. 

82.  (a)  What  is  the  usual  difference  in  shape  between  the 
red  corpuscles  of  the  blood  in  the  mammalia  and  those  in  the 
oviparaf     {April,  1896.) 

83.  (b)  Describe  the  red  blood  corpuscles,  (c)  Give  the 
best  known  and  most  important  function  of  the  red  blood 
corpuscles.    {January,  1901.) 

84'  (c)  State  the  functions  of  the  red  blood  corpuscles  and 

(d)  mention  their  nurnber  as  compared  with  the  mmiber^f 
the  white  blood  corpuscles.     {January,  1902.) 

85.  (d)  Name  the  proportions  of  white  to  red  corpuscles 
in  human  blood,  (e)  Describe  each  variety.  (January^ 
1896.) 

86.  (e)  Describe  a  white  blood  corpuscle,  (b)  a  red  blood 
corpuscle,  (d)  What  is  the  relative  proportion  of  the  white 
to  the  red  corpuscles  in  human  blood  f    {April,  1897.) 

82  to  86.  (a)  Collins  and  Rockwell's  Physiology,  pages 
32  to  34;  (b)  pages  32  and  33;  (c)  page  35;  (d)  page  32; 

(e)  pages  38  and  32. 

87.  (a)  What  are  the  physical  properties  of  the  white  blood 
corpuscles?     {June,  1894.) 

88.  (a)  Describe  the  white  blood  corpuscles  and  (b)  their 
function.     {June,  1892.) 

89.  (a)  Describe  the  white  blood  corpuscles,  giving  (c) 
source,  (d)  composition,  and  (a)  properties.    {April,  1899.) 

90.  What  are  the  accepted  theories  as  to  the  origin  of  (e) 
the  red  blood  corpuscles,  (c)  the  white  blood  corpuscles P  (May^ 
1900.) 


39  PHYSIOLOGY  AND  HYGIENE.  \ 

87  to  90.  (a)  Collins  and  Rockwell's  Physiology,  page 
38;  (b)  page  40;  (c)  page  39;  (d)  page  39;  (e)  page  34. 

91.  (a)  Describe  hcemoglohin  and  (b)  mention  its  deriva- 
tives.    (Septeinber,  1898.) 

91.  (a)  Hsemoglobin,  the  most  important  constituent  of 
the  red  blood  corpuscles,  is  a  crystalline  body,  whose  exact 
percentage  composition  has  not  been  determined.  In 
addition  to  carbon,  hydrogen,  oxygen,  nitrogen,  and 
sulphur  it  contains  iron.  It  constitutes  over  90  per  cent, 
of  the  red  blood  corpuscles,  and  it  is  owing  to  this  substance 
that  these  corpuscles  are  capable  of  carrying  oxygen  to  the 
tissues  of  the  body.  It  readily  combines  with  oxygen  to 
form  oxyhsemoglobin;  when  not  thus  in  combination  it  is 
called  reduced  haemoglobin  or  haemoglobin,  (b)  The  chief 
derivatives  are:  oxy haemoglobin,  methsemoglobin,  carbon 
monoxide  haemoglobin,  nitric  oxide  haemoglobin,  haematin, 
Iiaematoidin,  haemin,  haemochromogen,  haemotoporphyrin. 
Bilirubin  and  urobilin  are  also  derived  from  haemoglobin. 

92.  What  is  blood  pigment?    {March,  1892.) 

92.  Blood  pigment  is  the  coloring  matter  of  the  blood; 
see  A.  91. 

93.  How  can  fresh  blood  stains  be  distinguished  from  older 
blood  stains?    (January,  1897.) 

93.  Fresh  blood  stains  are  of  a  bright-red  color,  contain 
haemoglobin,  and  may  show  corpuscles;  but  after  a  short 
time  of  exposure  (anywhere  from  one  to  five  or  six  days) 
the  stain  becomes  reddish-brown  or  brown,  and  contains 
haematin  crystals,  recognizable  in  solution  by  their  spectro- 
scopic absorption  bands. 

9 J}-,  (a)  What  causes  the  difference  in  color  of  the  arterial 
and  the  venous  blood?    (April,  1893.) 

95.  (b)  What  are  the  differences  between  arterial  and 
venous  blood?    (July,  1893.) 

96.  (b)  State  the  difference  between  arterial  blood  and 
venous  blood,  (c)  Give  the  characteristics  of  the  blood  in 
the  portal  vein.     (May,  1902.) 


40 


PHYSIOLOGY  AND  HYGIENE. 


97.  (d)  Describe  the  physical  appearance  and  character- 
istics of  the  blood,  (b)  Compare  arterial  blood  with  venous 
blood.     (May,  1899.) 

94  to  97.  (a)  Collins  and  Rockwell's  Physiology,  page 
30;  (b) 


Arterial  Blood. 


Color. — Bright  red,  monochroic  ; 
oxy  hsemoglob  in . 

Specific  Gravity. — Less. 

Number  of  Corpuscles. — Relatively- 
less  ;  blood  more  diluted. 

Temperature. — Slightly  warmer  in 
general. 

Coagulation. — More  coagulable. 
Fibrinogen. — More. 
General  Composition  — More  uni- 
form. 
Gas. — More  O,  less  COj. 

Water. — More. 


Urea  and  Extractives. — Less. 

Glucose . — More . 

Fat. — Less. 

Fibrin. — More. 

Serum  Albumin. — Less. 

Salts. — More. 


Venous  Blood. 


Purple,  dichroic  ;  reduced  haemo- 
globin. 

More. 

Relatively  more  ;  blood  more  con- 
centrated. 

Slightly  cooler,  but  exceptions; 
warmest  blood  in  the  body  found 
in  the  hepatic  vein. 

Less  coagulable. 

Less,  except  in  mesenteric  vein. 

Numerous  local  variations. 

More  COj:  less  O,  except  pulmo- 
nary veins. 

Less  ;  transudation  of  water 
through  the  capillaries  causes 
venous  blood  to  be  more  con- 
centrated. 

More ;  except  renal  vein. 

Less. 

More. 

Less. 

More. 

Less. 


(From  The  Reference  Handbook  of  the  Medical  Sciences.) 

(c)  The  blood  in  the  portal  vein  contains  more  water  and 
proteids,  fewer  red  corpuscles,  and  on  coagulation  gives 
a  less  firm  clot;  and  see  A.  114  (c);  (d)  Collins  and  Rock- 
well's Physiology,  pages  30  to  32. 

98.  Give  (a)   the  composition,  (b)  reaction,  and  (c)  uses 
of  blood.     (June,  1901.) 

99.  Describe  briefly  (a)  the  composition  and  (c)  functions 
of  the  blood.     (June,  1892.) 


41  PHYSIOLOGY  AND  HYGIENE, 

100.  (c)  What  are  the  uses  of  the  hlood?    (April,  1894.) 

101.  (c)  Name  four  uses  of  the  hlood.    {June,  1895.) 

102.  (d)  What  are  the  uses  of  the  hlood  serum?  {June, 
1892.) 

98  to  102.  (a)  See  A.  to  947  (a) ;  (b)  Collins  and  Rock- 
well's Physiology,  page  31;  (c)  page  46;  (d)  page  46. 

2.  The  Circulation  of  the  Blood. 

103.  Give  (a)  the  uses  of  the  hlood,  (b)  the  normal  circu- 
latory velocity  of  the  hlood.    {January,  1900.) 

10 4 .  (b)  Compare  arteries,  veins,  and  capillaries  in  respect 
to  rapidity  of  the  hlood  stream.    {May,  1901.) 

103  and  104.  (a)  See  Q.  99  to  102  (c);  (b)  Collins  and 
Rockwell's  Physiology,  page  57. 

105.  (a)  Name  the  apparatus  concerned  in  the  main- 
tenance of  the  normal  flow  of  hlood  in  the  circulation.  {No- 
vemher,  1893.) 

106.  (b)  Descrihe  the  circulation  of  the  hlood.  {Novemher, 
1892.) 

107.  (b)  State  the  manner  in  which  hlood  circulates 
through  the  heart  and  the  lungs,  heginning  at  the  right  auricle. 
{May,  1901.) 

108.  (b)  Descrihe  the  circulation  of  the  hlood,  commencing 
with  the  right  auricle.    {May,  1893.) 

109.  (b)  Descrihe  the  circulation  of  the  hlood,  heginning  at 
the  left  ventricle.     {April,  1897.) 

110.  (c)  Give  the  shortest  course  a  drop  of  hlood  can  take 
in  passing  from  the  left  to  the  right  ventricle  of  the  heart  in 
normal  circulation.     {April,  1893.) 

111.  What  causes  (d)  the  circulation  of  the  hlood,  (e)  the 
heating  of  the  pxdsef     {May,  1897.) 

105  to  111.  (a)  Collins  and  Rockwell's  Physiology,  page 
48;  (b)  pages  49  to  51.  (c)  The  shortest  course  a  drop  of 
blood  can  take  in  passing  from  the  left  to  the  right  ventricle 
of  the  heart  is  to  leave  the  left  ventricle,  enter  the  aorta, 


42  PHYSIOLOGY  AND  HYGIENE. 

then  one  of  the  coronary  arteries,  and,  leaving  it  by  one 
of  its  early  branches,  return  to  the  right  auricle  by  the 
coronary  vein,  then  pass  through  the  tricuspid  valve  into 
the  right  ventricle,  (d)  Collins  and  RockwelPs  Physiology, 
page  56.  (e)  The  beating  of  the  pulse  is  caused  by  the 
contractions  of  the  heart,  the  resistance  produced  by  the 
friction  of  the  blood  in  the  vessels,  and  the  elasticity  of 
the  walls  of  the  bloodvessels. 

J 12.  (a)  Describe  the  circulation  of  the  blood  in  the  liver. 
{September,  1900.) 

113.  Describe  (a)  the  portal  circulation,  (b)  the  pulmonary 
circulation.    (May,  1900.) 

114'  Describe  (b)  the  pulmonary  blood  circulation,  (a)  the 
portal  blood  circulation,  (c)  What  changes  take  place  in  the 
character  of  the  blood  in  each?    (June,  1902.) 

115.  (a)  Describe  the  portal  circulation.    {June,  1897.) 

116.  Describe  (a)  the  portal  circulation,  (d)  the  renal 
circulation.     {May,  1895.) 

117.  (e)  Describe  the  foetal  circulation.     {June,  1892.) 

118.  (e)  Describe  the  facial  circulation.     (June,  1898.) 

119.  (f)  Give  the  physiological  course  of  the  blood  through 
the  heart,  (e)  Describe  the  foetal  circulation.   (January,  1901.) 

112  to  119.  (a)  '^To  understand  the  distribution  of  the 
bloodvessels  in  the  liver,  it  will  be  well  to  trace,  first,  the 
two  bloodvessels  and  the  duct  which  enter  the  organ  on 
the  under  surface  at  the  transverse  fissure,  viz.,  the  portal 
vein,  hepatic  artery,  and  hepatic  duct.  Running  together 
through  the  substance  of  the  liver,  they  are  contained  in 
small  channels  called  portal  canals,  their  immediate  invest- 
ment being  a  sheath  of  areolar  tissue  continuous  with 
Glisson's  capsule.  To  take  the  distribution  of  the  portal 
vein  first :  In  its  course  through  the  liver  this  vessel  gives 
off  small  branches  which  divide  and  subdivide  between  the 
lobules  surrounding  them  and  limiting  them,  and  from  this 
circumstance  called  mier-lobular  veins.  From  these  small 
vessels  a  dense  capillary  network  is  prolonged  into  the 


43  PHYSIOLOGY  AND  HYGIENE. 

substance  of  the  lobule,  and  this  network  gradually  gather- 
ing itself  up,  so  to  speak,  into  larger  vessels,  converges 
finally  to  a  single  small  vein,  occupying  the  centre  of  the 
lobule,  and  hence  called  m^ra-lobular.  The  small  intra- 
lobular veins  discharge  their  contents  into  veins  called 
suh-lohulai,  while  these  again,  by  their  union,  form  the 
main  branches  of  the  hepatic  veins,  which  leave  the  pos- 
terior border  of  the  liver  to  end  by  two  or  three  principal 
trunks  in  the  inferior  vena  cava,  just  before  its  passage 
through  the  diaphragm.  The  st^6-lobular  and  hepatic  veins, 
unlike  the  portal  vein  and  its  companions,  have  little  or 
no  areolar  tissue  around  them,  and  their  coats  being  very 
thin,  they  form  little  more  than  mere  channels  in  the  liver 
substance  which  closely  surrounds  them.  The  hepatic 
artery,  the  chief  function  of  which  is  to  distribute  blood 
for  nutrition  to  Glisson's  capsule,  the  walls  of  the  ducts, 
and  bloodvessels,  and  other  parts  of  the  liver,  is  dis- 
tributed in  a  very  similar  manner  to  the  portal  vein,  its 
blood  being  returned  by  small  branches  either  into  the 
ramifications  of  the  portal  vein,  or  into  the  capillary 
plexus  of  the  lobules  which  connect  the  inter-  and  intra- 
lobular  veins.  The  hepatic  duct  divides  and  subdivides 
in  a  manner  very  like  that  of  the  portal  vein  and  hepatic 
artery,  the  larger  branches  being  lined  by  cylindrical,  and 
the  smaller  by  small  polygonal  epitheliimi.  The  bile- 
capillaries  commence  between  the  hepatic  cells,  and  are 
boimded  by  a  delicate  membranous  wall  of  their  own. 
They  appear  to  be  always  boimded  by  hepatic  cells  on  all 
sides,  and  are  thus  separated  from  the  nearest  blood 
capillary  by  at  least  the  breadth  of  one  cell.^'  (Kirkes' 
Physiology.)  (b)  ''While  the  lungs  are  nourished  by  the 
bronchial  arteries,  it  is  by  the  means  of  the  pulmonary 
arteries  that  the  venous  blood  is  carried  to  them  from  the 
right  side  of  the  heart  and  aerated.  The  pulmonary  artery, 
arising  from  the  right  ventricle  of  the  heart,  soon  divides 
into  a  right  and  left  branch  for  either  lung.  Following  the 
bronchus  and  bronchial  tubes,  the  artery  divides  and  sub- 


44 


PHYSIOLOGY  AND  HYGIENE, 


divides,  the  branches  becoming  smaller  and  smaller  as  they 
approach  the  primary  lobules,  imtil  finally  they  terminate 
as  the  pulmonary  capillaries.  The  terminal  arterial  capil- 
laries surround  each  alveolus  or  air  cell  as  a  vascular 
circle,  which  anastomoses  with  those  of  the  adjacent 
alveoli.  From  these  vessels  arise  a  capillary  network,  so 
closely  set  that  the  meshes  are  even  smaller  than  the 
diameter  of  the  vessels  themselves,  the  latter  having  usually 


a  diameter  of  from  -^  to  2-^  of  a  mm. 


2000 


to 


^of  an 


inch) .  This  network  supports  the  bottom  of  each  air  cell,  and 
the  blood  that  it  carries  is  separated  from  the  air  of  the 
cells  only  by  its  wall  and  the  extremely  delicate  epithelial 
lining  of  it.  The  carbon  dioxide  of  the  venous  blood 
conveyed  to  the  lungs  by  the  pulmonary  artery  is  thus 
separated  from  the  oxygen  of  the  air  within  the  air  cells 
brought  by  the  trachea  by  nothing  but  the  wall  of  the 
capillary  and  epithelium  of  the  air  cell.  .  .  .  From  the 
capillary  network  surrounding  the  air  cells  the  pulmonary 
veins  arise,  which,  uniting  with  each  other,  gradually  form 
four  larger  trunks,  which  finally  terminate  in  the  left 
auricle  of  the  heart  and  convey  to  it  the  aerated  oxygenated 
blood  to  be  distributed  by  the  arterial  system  to  all  parts 
of  the  body."  (Chapman's  Physiology.)  (c)  For  the  changes 
occurring  in  the  blood  during  the  pulmonary  circulation, 
see  A.  95  to  98  (b).  In  the  portal  circulation  the  following 
changes  have  been  observed: 


Portal  Vein. 


More  plasma. 
Fewer  corpuscles. 
More  fat. 

More  sugar  during  digestion,  and 
less  afterwards. 


Hepatic  Vein. 


Less  plasma. 
More  corpuscles. 
Less  fat. 

Less  sugar  during  digestion,  and 
more  afterwards. 


(d)  CoUins  and  Rockwell's  Physiology,  page  128;  (e)  page 
293:  (f)  page  49. 


45  PHYSIOLOGY  AND  HYGIENE. 

3.  The  Heart. 

120.  Describe  systole  and  diastole  and  their  causes.  (Sep- 
tember, 1895.) 

120.  Collins  and  Rockwell's  Physiology,  page  61. 

121.  Describe  the  topography  of  the  normal  heart  in  an 
adult  male.     {January,  1897.) 

121.  ^'In  order  to  show  the  extent  of  the  heart  in 
relation  to  the  front  of  the  chest,  draw  a  line  from  the 
lower  border  of  the  second  left  costal  cartilage,  one  inch 
from  the  sternum,  to  the  upper  border  of  the  third  right 
costal  cartilage,  half  an  inch  from  the  sternum.  This 
represents  the  base  line  or  upper  limit  of  the  organ.  Take 
a  point  an  inch  and  a  half  below  and  three-quarters  of  an 
inch  internal  to  the  left  nipple — that  is,  about  three  and 
a  half  inches  to  the  left  of  the  median  line  of  the  body. 
This  represents  the  apex  of  the  heart.  Draw  a  line  from 
this  apex  point,  with  a  slight  convexity  downward,  to  the 
junction  of  the  seventh  right  costal  cartilage  to  the  sternum. 
This  represents  the  lower  limit  of  the  heart.  Join  the  right 
extremity  of  the  first  line — that  is,  the  base  line — with  the 
right  extremity  of  this  line — that  is,  to  the  seventh  right 
chondrosternal  joint — with  a  slight  curve  outward,  so  that 
it  projects  about  an  inch  and  a  half  from  the  middle  line 
of  the  sternum.  Lastly,  join  the  left  extremity  of  the  base 
line  and  the  apex  point  by  a  line  curved  slightly  to  the 
left."     (Gray's  Anatomy,  page  470.) 

122.  What  is  the  office  of  the  columnce  carnecef  (May,  1894-) 

122.  To  prevent  too  great  dilatation  of  the  ventricles; 
to  regulate  their  contraction;  and  to  prevent  the  auriculo- 
ventricular  valves  from  being  turned  into  the  auricles. 

123.  Describe  the  mechanism  of  the  mitral  valve.  (March, 
1892.) 

124.  Describe  the  mechanism  in  the  opening  and  closing 
of  the  aortic  valves.     (March,  1893.) 

123  and  124.  Collins  and  Rockwell's  Physiology,  page  53. 


46 


PHYSIOLOGY  AND  HYGIENE. 


125.  (a)  Define  heart  sounds.     (June,  1898.) 

126.  (a)  Describe  normal  heart  sounds.    (April,  1899.) 

127.  (a)  What  are  the  normal  heart  sounds?  (b)  Where, 
topographically,  are  the  heart  sounds  most  audible?  (June, 
1900.) 

128.  (a)  Describe  the  normal  heart  sounds,  (b)  How  and 
where  should  the  stethoscope  or  the  ear  be  placed  to  hear  these 
sounds  to  best  advantage?    (June,  1901.) 

129.  (c)  What  causes  the  first  sound  of  the  heart?   (April, 

1894.) 

ISO.  (d)  What  causes  the  second  sound  of  the  heart? 
(September,  1898.) 

131.  (c),  (d)  Describe  the  factors  ivhich  cause  the  heart 
sounds.     (September,  1896.) 

125  to  131.  (a)  Collins  and  Rockwell's  Physiology,  page 
62;  (b) 


Fig.  4. — From  above  downward,  showing  the  anatomical  positions 
of  the  puhnonic,  aortic,  mitral,  and  tricuspid  valves.  The  arrow-heads 
show  their  respective  sites  of  audibility.  Shaded  portion  shows  part 
of  left  heart  projecting  beyond  the  right  heart. 


47  PHYSIOLOGY  AND  HYGIENE. 

(c)  Collins  and  RockwelFs  Physiology,  page  63;  (d)  page 
63. 

ISS.  What  are  the  causes  of  the  apex  heat  of  the  heart? 
{May,  1900.) 

132.  Collins  and  Rockwell's  Physiology,  page  61. 

133.  What  are  the  causes  within  physiological  limits  of 
the  increase  of  the  pulse  rate?    {June,  1892.) 

133.  Collins  and  Rockwell's  Physiology,  page  61. 

13Ji..  (a)  What  effect  is  produced  on  the  hearths  action  by 
stimulation  of  the  cardio-inhihitory  centre?    {May,  1896.) 

135.  (b)  In  what  manner  is  the  heart  heat  influenced  by 
the  pneumogastric  nerve?  What  is  the  average  number  of 
heart  beats  per  minute  in  (c)  a  child  aged  one  year,  (d)  an 
adult  aged  seventy?     {September,  1900.) 

136.  (e)  What  is  the  average  rate  of  heart  beat  in  the 
infant;  the  adult;  and  old  age?    {September,  1893.) 

137.  (f)  Give  the  extremes  of  slowness  and  rapidity  of  the 
hearths  action  which  are  consistent  with  physical  vigor, 
and  with  ability  to  perform  manual  labor.  {January, 
1895.) 

134  to  137.  (a)  Collins  and  Rockwell's  Physiology,  page 
65;  (b)  page  65;  (c)  108  to  130  beats;  (d)  60  to  65  beats; 
(e)  Collins  and  Rockwell's  Physiology,  page  61;  (f)  ordi- 
narily these  limits  are  placed  at  about  60  and  90  beats  per 
minute,  but  occasionally  these  extremes  may  be  ex- 
ceeded. ^ 

138.  What  do  you  understand  by  blood  pressure?  {Sep- 
tember, 1892.) 

139.  Describe  the  conditions  loithin  nor7nal  physiological 
limits  which  increase  arterial  blood  pressure.  {January, 
1892.) 

Ufi.  State  three  ways  in  which  a  decrease  of  blood  pressure 
in  the  arteries  may  be  produced.    {June,  1902.) 


48 


PHYSIOLOGY  AND  HYGIENE. 


138  to  140.  ''Blood  pressure  is  the  force  exercised  by  the 
blood  against  the  walls  of  the  bloodvessels.  This  is  modi- 
fied, of  course,  by  the  condition  of  the  heart,  the  elasticity 
of^,the  vessels,  etc.  The  causes  of  alteration  in  the  blood- 
pressure  may  be  tabulated  as  follows  (Brunton) : 


May  be  raised — 


1.  By    the    heart    beating    more 

quickly. 

2.  By    the    heart    beating    more 

vigorously  and  more  com- 
pletely, and  sending  more 
blood  into  the  aorta  at  each 
beat. 

3.  By  contraction  of  the  arterioles, 

retaining  the  blood  in  the 
arterial  system. 


May  be  lowered — 


By  the  heart  beating  more 
slowly. 

By  the  heart  beating  less  vigor- 
ously and  completely,  and  send- 
ing less  blood  into  the  aorta  at 
each  beat. 

By  dilatation  of  the  arterioles, 
allowing  the  blood  to  flow  more 
quickly  into  the  veins. 
By  deficient  supply  of  blood  to 
the  left  ventricle,  as  from  con- 
traction of  the  pulmonary  ves- 
sels or  obstruction  to  the  pass- 
age of  blood  through  them,  or 
from  stagnation  of  blood  in  the 
large  veins — e.  g.,  in  shock. 


(Dunglison's  Medical  Dictionary.) 

HI.  (a)  Describe  the  sphygmograph  and  state  its  use. 
(b)  Draw  a  normal  pulse  tracing.    {September^  1900.) 

142.  Make  a  sphygmographic  drawing  (b)  of  a  normal 
pulse;  (c)  of  a  dicrotic  pulse.    (April,  1897.) 

143.  (d)  Explain  by  drawing  or  otherwise  the  sphygmo- 
graphic tracing  in  mitral  insufficiency.    {January,  1896.) 

Uf-Jf..  (e)  Give  in  language  or  by  drawing  the  sphygmo- 
graphic tracing  in  aortic  insufficiency.     {June,  1895.) 

141  to  144.  (a) ''  Instruments  for  recording  the  pulsations 
of  an  artery  are  called  sphygmographs.  There  are  several 
forms.  The  one  in  most  common  use  by  clinicians  is  the 
Dudgeon   sphygmograph.     An   essential   feature   of   this 


49 


PHYSIOLOGY  AND  HYGIENE. 


instrument  is  a  system  of  compound  levers  which  transmits 
the  movement  of  the  arterial  wall  from  the  foot  or  pad 
which  rests  upon  the  skin  over  the  artery  to  a  tracing 
point  connected  with  the  last  lever.  This  system  of  levers 
multiplies  the  motion  of  the  foot  about  fifty  times.  A 
second  feature  of  the  instrument  is  a  recording  apparatus 
consisting  of  a  clockwork  which  turns  a  pair  of  small 
cylinders,  between  which  runs  a  shp  of  blackened  paper. 
The  tracing  point  rests  upon  this  paper  and  records  there 
the  magnified  movements  of  the  foot  or  pad.  The  sphygmo- 
graph  has  the  great  advantage  that  it  makes  a  record  of 
the  variation  of  pressure,  and  when  properly  used  may 
reveal  many  facts  about  the  general  condition  of  the 
circulatory  system."  (Hall's  Text-hook  of  Physiology, 
page  172.) 
(b) 


Fig.  5. — Sphygmographic  tracing  of  normal  pulse. 

a,  h,  percussion  up-stroke;  a,  h,  c,  percussion  wave;  c,  d,  e,  tidal  wave; 

«,  /,  g,  dicrotic  wave;  d,  e,  f,  aortic  notch;  /,  g,  diastolic  period. 

(c) 


Fig.  6.- 


(d) 


-Low-tension  dicrotic  pulse  (pneumonia  eight  hours  before 
death). 


Fig.  7. — Mitral  regurgitation. 


so  PHYSIOLOGY  AND  HYGIENE. 

(e) 


Fig.  8. — Aortic  regurgitation. 


4.  The  Bloodvessels. 


145.  (a)  Describe  the  structure  of  arteries,  (b)  How  do 
arteries  exercise  their  function?     (January,  1901.) 

llfi.  (a)  (Jme  the  structural  differences  between  arteries, 
veins,  and  capillaries.     (September,  1896.) 

H7.  How  do  veins,  arteries,  and  capillaries  differ  as  to 

(a)  structure,  (b)  function?    (September,  1901.) 

148.  How  do  arteries  and  veins  differ  in  (a)  structure, 
(h)  function?     (September,  1901.) 

145  to  148.  (a)  Collins  and  RockwelPs  Physiology,  pages 
54  and  55;  (b)  pages  54  to  60,  and  66  to  68. 

149.  (a)  What  is  the  relation  of  the  capillaries  to  the 
circulatory  system?     (September,  189 4-) 

150.  (b)  What  physiological  process  takes  place  in  the 
capillaries?     (September,  1892.) 

151.  (c)  Describe  the  movements  of  the  blood  corpuscles 
in  the  capillaries  and  explain  the  phenomena  of  diapedesis. 
(September,  1899.) 

149  to  151.  (a)  Collins  and  Rockwell's  Physiology,  pages 
54  and  49.  (b)  Chiefly  nutrition,  oxidation,  and  excretion; 
it  is  in  the  capillary  circulation  that  all  the  changes  between 
the  blood  and  the  tissues  take  place,  (c)  Collins  and  Rock- 
well's Physiology,  pages  59  and  60. 

152.  (a)  Give  the  causes  of  the  flow  of  the  blood  in  the 
veins.     (May,  1893.) 

153.  (a)   How  is  the  venous  blood  current  maintainedf 

(b)  What  arteries  carry  venous  blood?    (May,  1898.) 


51  PHYSIOLOGY  AND  HYGIENE. 

152  and  153.  (a)  ''(1)  Residuum  of  heart  pressure 
exerted  through  the  capillaries.  (2)  Action  of  diaphragm 
and  intercostals  in  causing  negative  intrathoracic  pressure 
during  inspiration,  actually  lifting  the  column  of  blood  in 
the  ascending  vena  cava.  (3)  Ventricular  systole  causing 
negative  intrathoracic  pressure  at  end  of  systole  and 
beginning  of  diastole,  through  the  sudden  decrease  in 
volume  of  heart.  (4)  Action  of  muscles  pressing  upon  the 
veins.  (5)  The  force  of  gravitation,  which  materially 
assists  in  filling  the  ventricles  and  the  left  auricle,  as  well 
as  in  assisting  the  flow  in  the  jugulars  and  descending 
or  anterior  vena  cava,  while  it  retards  the  flow  in  the 
veins  below  the  heart.  (6)  Contraction  of  the  mouths  of 
the  veins.  (7)  Under  certain  circumstances,  positive  intra- 
abdominal pressure,  during  inspiration  and  expiration 
(forced).  (8)  Negative  intrathoracic  pressure  through 
pushing  out  of  the  anterior  thoracic  wall  by  the  apex  beat 
of  the  heart. 

'^Of  these  forces  the  first  three  are  the  efficient  forces 
of  venous  circulation;  the  remaining  forces  are  either  so 
small  in  relation  to  the  first  three  that  they  may  be  ignored 
or  they  act  only  under  special  conditions.  The  force  of 
gravitation,  though  it  assists  the  downward  flow  in  all 
veins  and  retards  the  upward  flow,  may  rather  be  recorded 
among  the  factors  which  modify  venous  circulation.  Any 
action  of  the  walls  of  the  abdominal  cavity  (descent  of 
diaphragm  in  inspiration  or  contraction  of  the  lateral  walls 
in  expiration)  will  force  toward  the  thoracic  cavity  any 
blood  in  the  abdominal  veins,  but  it  will,  to  the  same 
degree,  keep  out  of  the  abdominal  veins  any  blood  in  the 
legs.''  (Hall's  Text-hook  of  Physiology,  page  178.)  (b)  The 
pulmonary  artery  and  its  two  branches,  the  right  and  left 
pulmonary  arteries. 

154-  What  are  the  variations  in  the  composition  of  the 
hlood  in  the  different  parts  of  the  body?    (September,  1898.) 

154.  See  Q.  96  and  97;  in  addition  to  the  variations 
there  given,  the  chief  are  as  follows: 


52  PHYSIOLOGY  AND  HYGIENE. 

''1.  The  Blood  of  the  Capillaries. — Virchow  has  noted  that 
the  blood  from  the  capillaries  does  not  coagulate  after 
death  even  when  exposed  to  the  air,  which  apparently 
indicates  some  modification  of  the  fibrin  or  fibrin  ferment. 

"2.  The  Blood  of  the  Mesenteric  Vein. — More  fibrinogen  is 
found  in  this  vein  than  in  arterial  blood. 

"3.  The  Blood  of  the  Portal  and  Hepatic  Veins. — Drosdoff 
has  observed  in  dogs  fed  with  meat,  bread,  and  milk 
that  the  portal  vein  contains  fewer  corpuscles  and  more 
plasma  than  that  of  the  hepatic.  There  is  also  more  fatty 
material  present  in  the  portal,  which  may  apparently  be 
stored  up  in  the  liver.  During  digestion  the  portal  vein 
contains  more  sugar  than  the  hepatic,  but  later  the  reverse 
is  the  case,  although  it  is  not  likely  that  the  portal  vein 
is  at  any  time  entirely  destitute  of  it. 

"4:.  The  Blood  of  the  Splenic  Vein. — The  evidence  is  con- 
flicting here.  Some  have  claimed  that  a  larger  number  of 
corpuscles  are  present  in  this  blood,  while  others  hold  that 
they  are  fewer  and  are  destroyed  in  the  spleen  as  well  as 
in  the  liver. 

"5.  The  Blood  of  the  Renal  Vessels. — The  differences  are 
best  shown  in  the  following  table: 


Renal  Artery. 

Renal  Vein 

Water          .... 
Solids          .... 

.    790 
.    210 

778 
222 

1000 

1000 

Albuminoids 
Mineral  salts 

Urea 

Uric  acid  and  kreatin 
Oxygen       .... 
Carbon  dioxide  . 

.     less. 

,     more. 

it 

tt 
tt 
tt 

more. 

less. 
tt 

tt 

if 

tt 

'^Very  briefly,  there  is  loss  of  water,  salts,  urea,  CO2,  and 
extractive  materials. 

''6.  The  Blood  of  the  Glands. — The  blood  which  leaves  a 
resting  gland  is  dark  and  possesses  the  ordinary  characters 
of  venous  blood;  that  leaving  an  active  gland  is  brighter 


53  PHYSIOLOGY  AND  HYGIENE. 

(Bernard)  and  contains  less  COj  than  common  venous 
blood,  because  a  certain  amount  of  the  COj  is  given  off 
in  the  fluid  secreted  by  the  glands,  especially  the  salivary.'' 
(Reference  Handbook  of  the  Medical  Sciences.) 

155.  Through  what  mediums  is  the  hlood  (a)  relieved  of 
effete  matter,  and  (b)  provided  with  new  material?  {June, 
1899.) 

■  155.  (a)  The  blood  is  relieved  of  effete  matter  through 
the  lungs,  liver,  kidneys,  and  skin;  (b)  it  is  provided  with 
new  material  through  the  alimentary  canal,  skin  (absorp- 
tion), lungs,  lymphatics,  liver,  and  spleen. 

156.  (a)  Mention  the  erectile  tissues  of  the  body,  and  (b) 
explain  their  characteristic  functions.     {January,  1901.) 

156.  (a)  The  corpora  cavernosa  and  corpus  spongiosum 
of  the  penis,  the  clitoris,  the  bulbi  vestibuli,  the  tissue 
covering  the  turbinated  bones  of  the  nose,  and,  to  a  slight 
extent,  the  nipple,  (b)  ^'Erectile  tissues  are  tissues  suscep- 
tible of  turgescence  and  increase  of  size,  and  formed  of  a 
collection  of  arteries  and  veins  intermixed  with  nervous 
filaments;  the  veins  are  varicose  and  contained  in  spaces 
formed  by  trabeculse  of  fibrous  tissue,  being  prolongations 
from  the  fibrous  envelope."  (Dunglison's  Medical  Dic- 
tionary.) 

V.  RESPIRATION. 

157.  Define  the  function  of  the  mucous  membrane  of  the 
respiratory  tract?     {June,  1893.) 

157.  The  functions  of  the  mucous  membrane  of  the 
respiratory  tract  are:  To  warm  and  moisten  the  inspired 
air,  and  to  keep  foreign  matter  (such  as  dust,  germs,  and 
noxious  gases)  out  of  the  respiratory  tract.  That  of  the 
alveoli  permits  osmotic  interchange  of  gases  between  the 
blood  of  the  capillary  network  and  the  air  in  the  alveoli. 
The  mucous  membrane  of  the  nose  also  contains  the 
peripheral  organs  of  the  sense  of  smell, 

158.  (a)  What  is  the  purpose  of  respiration?  (b)  Give 
the  mechanism  of  respiration.     {January,  1898.) 


54  PHYSIOLOGY  AND  HYGIENE. 

159.  (b)  Describe  the  mechanism  of  respiration.  (March^ 
1892.) 

160.  Explain  (b)  the  mechanical  action  and  (c)  the  physi- 
ology of  respiration.     {May,  1894.) 

161.  (c)  Give  the  physiology  and  (b)  the  mechanism  of 
respiration.     (September,  1896.) 

162.  (d)  Describe  in  full  a  normal  respiration.  (No- 
vember, 1892.) 

163.  (c)  Give  the  physiology  of  respiration,  (e)  What  is 
reserve  air?    (September,  1901.) 

WJf..  (b)  Give  the  mechanism  of  respiration.  Define  (f) 
tidal  air,  (g)  complemental  air,  (e)  reserve  air,  (h)  residual 
air.     (June,  1898.) 

165.  Define  (e)  reserve  air,  (h)  residual  air,  (g)  comple- 
mental air,  (f)  tidal  air.    (June,  1896.) 

166.  (h)  What  is  meant  by  the  residual  air?  (March^ 
1893.) 

167.  (i)  Explain  the  process  of  expiration.    (June,  1894.) 
158  to  167.  (a)  The  purpose  of  respiration  is  to  introduce 

oxygen  into  the  system,  and  to  excrete  carbon  dioxide; 
(b)  Collins  and  Rockwell's  Physiology,  pages  75,  and  78 
to  81;  (c)  pages  84  and  85;  (d)  page  75;  (e)  page  82;  (f) 
page  82;  (g)  page  83;  (h)  page  83;  (i)  page  81. 

168.  (a)  State  the  changes  in  the  diameter  of  the  chest  in 
inspiration  and  in  expiration.     (April,  1896.) 

169.  (b)  What  muscles  are  engaged  in  ordinary  inspira- 
tion? (c)  What  muscles  are  involved  in  extraordinary  or 
forced  inspiration?     (September,  1895.) 

170.  (d)  What  muscles  are  brought  into  action  during 
respiration?     (January,  1893.) 

171.  (e)  How  is  the  diaphragm  affected  in  expiration? 
State  cause.     (May,  1900.) 

172.  (e)  Describe  the  mechanism  of  the  diaphragm  in 
respiration.     (May,  1893.) 

173.  Give  the  mechanism  of  the  diaphragm  in  (e)  respira- 
tion, (f)  hiccough.     (September,  1897.) 


55  PHYSIOLOGY  AND  HYGIENE. 

174'  (g)  Describe  the  action  of  the  muscles  and  the  move- 
ments of  the  ribs  in  the  complete  act  of  inspiration  and 
expiration.     (June,  1901.) 

175.  Describe  (h)  the  nervous  and  (d)  muscular  mechanism 
of  the  respiratory  act.     {June,  1900.) 

168  to  175.  (a)  Collins  and  Rockwell's  Physiology,  pages 
78  to  81;  (b)  pages  78  to  80;  (c)  page  81:  (d)  pages  78  to 
82;  (e)  pages  78  to  81  and  86;  (f)  page  89;  (g)  pages  79 
to  81;  (h)  pages  85  to  87. 

176.  (a)  How  do  the  movements  of  the  chest  in  respiration 
influence  the  circulation?    (March,  1893.) 

177.  (b)  Do  variations  in  the  rate  and  force  of  respiration 
affect  the  heart,  and,  if  so,  in  what  manner?     (May,  1893.) 

178.  (b)  What  effect  on  the  heart,  if  any,  has  a  variation 
of  the  rate  and  force  of  respiration?    (September,  1897.) 

179.  (b)  Explain  how  variation  in  the  rate  and  force  of 
respiration  affects  the  heart.    (September,  1898.) 

176  to  179.  (a)  Collins  and  Rockwell's  Physiology,  page 
88;  (b)  page  88. 

180.  (a)  What  is  the  average  number  of  respirations  per 
minute  in  a  healthy  person?  (b)  Give  in  cubic  inches  of 
air  the  average  respiratory  capacity  of  a  healthy  adult.  (April, 
1898.) 

181.  (a)  What  is  the  normal  rate  of  respiration  per  minute 
in  (1)  a  child,  (2)  an  adult?  (c)  What  influences  regulate 
the  rate  of  respiration?     (January,  1902.) 

182.  (d)  What  is  the  normal  ratio  of  respiration  to  heart 
pidsations?     (June,  1897.) 

180  to  182.  (a)  "Frequency  of  respiration  in  various 
ages  CQuetelet):  newborn,  44;  5th  year,  26;  15th  to  20th 
years,^  20;  20th  to  25th  years,  18.7;  25th  to  30th  years,  16; 
30th  to  50th  years,  18.1."  (Dunglison's  Medical  Dictionary.) 
(b)  225  cubic  inches,  (c)  "The  chief  ways  in  which  the 
respirations  may  be  rendered  quicker  or  slower  are  the 
following,  according  to  Brunton: 


56 


PHYSIOLOGY  AND  HYGIENE. 


The  respira- 
tory move- 
ments may  -{ 
be   quick- 
ened by 


The  respira- 
tory move- 
ments may  \ 
be   render- 
ed slow  by 


Excitement  f  Stimulation  of  the  vagus. 

^f  ^^^.r^r,     ^    stimulation  of  optic  nerve, 
or  nerves,     i    -  .       .     -         -    ^ 


1 


Stimulation  of  acoustic  nerve. 


Greater  ex- 
citement 
of  respira- 
tory centre 


Diminished 
excitement 
of  respira-    | 
tory  centre  J 


r  Action  of  brain  (voluntary). 

J  Increased  temperature  of  blood. 

j  Increased  venosity  of  blood. 

i_  Action  of  drugs. 

1 


Diminished  venosity  of  blood. 
}-  Action  of  drugs. 
Action  of  brain  (voluntary). 


Nervous  in- 
fluences. 


f  Paralysis  of  vagi. 

I    Stimulation  of  superior  laryngeal  nerves. 

J    Stimulation  of  inferior  laryngeal  nerves. 

Stimulation  of  nasal  nerves. 

Stimulation  of  cutaneous  nerves. 

Stimulation  of  splanchnic  nerves. 


''Other  influences  exerted  on  the  frequency  of  respiration 
may  be  stated,  according  to  Guy :  while  standing  the  respira- 
tions are  22  to  the  minute;  while  sitting,  19;  while  lying 
down,  13.  The  newborn  child  breathes,  when  the  body 
is  in  a  vertical  position,  one-third  more  frequently.  Inges- 
tion of  food  increases  the  frequency  of  respiration;  during 
digestion  the  frequency  is  1.72  respirations  per  minute 
higher  (if  no  nourishment  had  been  taken  seven  hours 
previously) ;  eating  with  or  without  wine  increases  frequency 

1.22    (Vierordt) Greater    muscular    exercise 

increases  the  frequency  of  respiration.  In  the  sleeping 
adult  the  decrease  in  frequency  of  respiration  amoimts  to 
about  one-quarter  (Quetelet).''  (Dimglison's  Medical  Dic- 
tionary.)   (d)  Collins  and  Rockwell's  Physiology,  page  82. 

183.  (a)  How  does  respiration  affect  the  hloodf  (No- 
vemher,  1891.) 

184.  Give  (b)  the  mechanism  of  respiration',  (c)  the  chem- 
istry of  respiration.     {September,  1899.) 

185.  (d)  What  changes  are  produced  in  the  air  by  respira- 
tion?   {June,  1892.) 


57  PHYSIOLOGY  AND  HYGIENE. 

186.  (e)  How  does  the  air  of  crowded  rooms  become  joul? 
{November,  1891.) 

187.  (a)  What  effect  on  the  blood  has  respirationf  (d) 
What  changes  take  place  in  air  that  has  been  respired? 
{May,  1898.) 

188.  What  changes  are  produced  (d)  in  the  air  and  (a) 
in  the  blood  by  respirationf    {April,  1899.) 

189.  (e)  Mention  some  of  the  sources  of  impure  atmosphere. 
{June,  1892.) 

183  to  189.  (a)  Collins  and  Rockwell's  Physiology,  pages 
84,  85  and  88;  and  see  table  in  A.  95  to  98  (b) ;  (b)  Collins 
and  Rockwell's  Physiology,  pages  75  and  78  to  81;  (c) 
pages  84  and  85;  (d)  pages  83  and  84;  (e)  page  88,  and 
Egbert's  Hygiene  and  Sanitation,  pages  72  to  75. 

190.  Define  and  describe  respiratory  rhythm,  respiratory 
sounds.     {June,  1899.) 

190.  Collins  and  Rockwell's  Physiology,  page  82. 

191.  (a)  How  tnuch  air  is  required  jor  normal  respiration 
during  twenty-four  hours?     {April,  1893.) 

192.  (a)  How  many  cubic  feet  of  fresh  air  per  hour  are 
required  by  an  adult  f     {September,  1897.) 

19S.  (b)  How  much  space  is  required  for  a  single  indi- 
vidual in  a  sleeping  apartment  to  ensure  health?  {November ^ 
1891.) 

19 Jf..  (c)  Hov:  should  a  sleeping-room  be  ventilated  and  (d) 
what  should  be  its  temperature?     {September,  1892.) 

191  to  194.  (a)  Egbert's  Hygiene  and  Sanitation,  pages 
104  and  106;  (b)  page  106;  (c)  pages  113  and  114;  (d) 
page  123. 

195.  (a)  Describe  the  effect  upon  man  of  inhaling  carbon 
dioxide  gas.     {January,  1892.) 

196.  (b)  What  is  asphyxia?    {March,  1892.) 

197.  (b)  What  is  asphyxia?  (c)  How  is  asphyxia  pro- 
duced? (d)  What  are  the  causes  of  death  from  asphyxia? 
{April,  1898.) 


58  PHYSIOLOGY  AND  HYGIENE. 

198.  Describe  the  phenomena  of  (b)  asphyxia,  (e)  syncope, 
(f)  sleep.     (September,  1896.) 

199.  Give  the  causes  of  perverted  function  producing  (g) 
dyspnoea  and  (b)  asphyxia.     (September,  189Jf.) 

200.  Define  and  give  the  physiological  significance  of  (g) 
dyspnoea,  (h)  dysphagia,  (i)  apnoea.    (April,  1897.) 

201.  (e)  Describe  the  phenomena  of  syncope.  (January, 
1895.) 

202.  (e)  Define  and  describe  syncope.    (September,  1896.) 
208.  (e)  Describe  the  phenomena  of  syncope.    (September, 

1893.) 

195  to  203.  (a)  Egbert's  Hygiene  and  Sanitation,  pages 
75  to  78  and  95,  and  Collins  and  Rockwell's  Physiology, 
page  87 ;  (b)  page  87.  (c)  Asphyxia  is  produced  by  prevent- 
ing oxygen  from  reaching  the  blood,  by  obstruction  of  the 
respiratory  passages ;  or  by  inhaling  a  gas  without  oyxgen, 
or  one  which  strongly  tends  to  displace  oxygen  from  haemo- 
globin, as  CO;  or  by  interfering  with  the  interchange  of 
gases  which  should  take  place  between  the  air  and  the 
blood,  (d)  Death  is  caused  by  paralysis  of  the  respiratory 
centres  in  the  medulla,  due  to  the  action  of  the,  venous 
blood  and  lack  of  arterial  blood,  (e)  '^Syncope  is  the 
complete  and,  commonly,  sudden  loss  of  sensation  and 
motion,  with  considerable  diminution  or  entire  suspension 
of  the  pulsations  of  the  heart  and  the  respiratory  move- 
ments. Syncope  is  commonly  an  affection  of  no  conse- 
quence; sometimes  it  is  an  index  of  diseased  heart.'' 
(D^^R^\^on!^  Medical  Dictionary.)  (f)  '^  Sleep.  This  phe- 
nomenon is  one  of  many  instances  of  the  rhythmic  activities 
of  the  central  nervous  system.  From  time  to  time  all 
animals  with  a  well-developed  nervous  system  go  to  sleep, 
during  which  psychical  activity  is  at  its  lowest  point.  To 
reach  this  condition,  the  most  important  favoring  factor  is 
an  exclusion  of  all  or  most  of  the  impulses  from  the  central 
nervous  system.  In  a  well-known  case  of  Striimpell,  in 
which,  from  a  complicated  anaesthesia,  all  sensory  impulses 
were  limited  in  their  entrance  to  a  single  eye  and  a  single 


59  PHYSIOLOGY  AND  HYGIENE. 

ear,  the  patient  could  be  put  to  sleep  at  will  by  closing 
the  eye  and  stopping  the  ear.  In  addition,  sleep  has  been 
attributed  to  the  following  influences:  (1)  chemical  influ- 
ences; (2)  circulatory  influences;  (3)  histological  influences. 
Those  who  hold  to  chemical  influences  in  the  production  of 
sleep  maintain  that  during  normal  activity  of  the  body 
various  substances  are  formed  which  are  circulated  in  the 
blood,  and  directly  lessen  the  activity  of  the  nerve  cells  or 
indirectly  diminish  the  supply  of  blood  to  the  brain.  In 
the  theories  of  circulatory  influences  sl  fatigue  of  the  vaso- 
motor centre  is  looked  upon  as  the  cause  of  the  anaemia  of 
the  brain,  resulting  in  sleep.  In  the  third  set  of  theories 
sleep  is  supposed  to  be  due  to  a  separation  of  the  dendrites 
of  the  brain  cells,  due  to  a  shrinkage  of  the  nerve-cell  bodies 
or  to  an  intrusion  of  neuroglia  cells  between  them.  During 
sleep  the  capability  of  the  nervous  system  to  transmit 
impulses  is  not  entirely  lost.  The  cerebral  cortex  is  most 
affected,  the  spinal  cord  least.  The  close  relation  between 
dreams  and  external  stimuli  is  well  known,  and  it  has  been 
proved  experimentally  that  vasomotor  changes,  induced  by 
external  stimuli,  may  take  place  without  awakening  the 
sleeper.  The  period  of  deep  sleep  is  short  and  falls  within 
the  first  two  hours  after  its  onset.  During  this  time  the 
pulse  and  breathing  are  slower,  the  intestines  and  bladder 
are  at  rest,  the  output  of  carbon  dioxide  is  lessened,  and  the 
consumption  of  oxygen  still  more  so;  metabolism  is  less 
vigorous  and  the  temperature  falls.  The  respiration  is  said 
to  become  thoracic  in  type  and  to  take  on  a  more  or  less 
pronounced  Cheyne-Stokes  rhythm.  The  visual  axes  are 
probably  parallel  and  directed  to  a  distance,  but  the  pupils 
are  contracted.  The  latter  is  peculiar,  since  an  absence  of 
light  should  bring  about  dilatation.  This  is  connected 
perhaps  with  important  actions  taking  place  in  lower  levels 
of  the  brain.''  (Guenther's  Physiology,  page  197.)  (g) 
Collins  and  Rockwell's  Physiology,  page  87.  (h)  Dysphagia 
means  ^'difficulty  of  deglutition.  It  is  almost  always 
symptomatic  either  of  inflammation  or  of  other  disease  of 


60  PHYSIOLOGY  AND  HYGIENE. 

the  organs  of  deglutition,  or  of  incomplete  obstruction  of 
the  oesophagus,  by  some  obstacle  within  it,  or  by  a  neigh- 
boring tumor.  At  times  it  is  produced  by  spasms  or 
paralysis  of  the  oesophagus/'  (Dunglison's  Medical  Dic- 
tionary.)    (i)  Collins  and  Rockwell's  Physiology,  page  87. 

W4.  (a)  Where  is  the  respiratory  centre  located  in  man? 
(November,  1894.) 

205.  (a)  Where  is  the  respiratory  centre?  (b)  Where  is 
the  centre  of  defecation?    (May,  1896.) 

204  and  205.  (a)  Collins  and  Rockwell's  Physiology, 
page  86;  (b)  page  110. 

206.  What  post-mortem  tests  should  he  applied  to  prove 
that  air  has  entered  the  lungs  of  a  supposedly  stillborn  child? 
(June,  1895.) 

206.  ''  The  Hydrostatic  Test  (specific  gravitj^  of  lungs). — 
Its  general  principle  is,  that  before  respiration  the  limgs 
sink  rapidly  when  placed  in  water;  after  respiration  they 
float  high  in  that  fluid.  They  may,  however,  float  from 
other  causes,  viz.,  from  gases  developed  in  them  during 
putrefaction,  from  artificial  inflation,  and  from  emphysema. 
In  these  cases  the  contained  air  (or  gas)  can  be  forced  out 
of  the  lungs  by  compression  (to  be  applied  as  described 
below),  so  that  they  afterward  sink;  this  cannot  be  done 
after  perfect  respiration.  Artificial  inflation  does  not 
increase  w^eight  of  lungs.  After  imperfect  respiration  (as 
in  feeble  children,  or  those  who  take  only  a  few  gasps)  the 
air  can  be  expelled  by  compression,  so  that  this  is  not  to 
be  distinguished  from  artificial  inflation. 

'^Exceptionally,  the  lungs  may  sink  after  respiration, 
from  congestion,  inflammation,  and  other  diseases  having 
increased  their  weight.  Incising  the  lung  and  squeezing 
out  its  extra  blood,  or  cutting  it  up  and  compressing  each 
piece,  will  generally  cause  the  organ,  or  some  pieces  of  it, 
to  float,  if  the  child  has  breathed. 

"Application  of  Hydrostatic  Test. — Having  opened  chest, 
note  position  of  lungs  (before  respiration  they  occupy  a 


61  PHYSIOLOGY  AND  HYGIENE. 

small  space  at  upper  and  posterior  parts  of  thorax) ;  their 
volume  (of  course  increased  after  breathing);  their  shape 
(before  respiration,  borders  sharp  or  pointed;  after  it, 
rounded);  their  color  (before  breathing,  brownish-red;  after 
it,  pale  red  or  pink);  their  appearance  as  regards  disease 
and  putrefaction;  and  whether  they  crepitate  on  pressure 
(as  they  will  after  respiration). 

'^Take  out  lungs,  with  heart  attached,  and  place  them 
in  pure  water  having  temperature  of  surrounding  air. 
Note  whether  they  float  (high  or  low),  or  sink  (slowly  or 
rapidly).  Separate  them  from  the  heart;  weigh  them 
accurately,  and  then  place  them  in  water  again,  and  note 
sinking  or  floating  as  before.  Subject  each  lung  to  pressure 
with  the  hand,  and  note  sinking  or  floating  again.  Cut 
each  limg  in  pieces  and  test  floating  again.  Take  out  each 
piece,  wrap  it  in  a  cloth,  and  compress  with  fingers  as  hard 
as  possible,  and  test  floating,  etc.,  as  before.  The  crucial 
test  of  perfect  respiration  is  each  piece  floating  after  the 
most  vigorous  compression.''  (King's  Manual  of  Obstetrics j 
page  600.) 

VI.  DIGESTION,   FOOD,  AND  NUTRITION. 

1.  Digestion. 

207.  (a)  What  is  meant  hy  digestion?    {November,  1892.) 

208.  (a)  What  is  digestion?  (b)  Describe  the  stages  of 
deglutition.     {April,  1896.) 

209.  (b)  How  is  deglutition  accomplished?    {June,  1902.) 

210.  (b)  Give  a  description  of  the  act  of  deglutition  and 
(c)  mention  the  muscles  brought  into  action  in  swallowing. 
{April,  1898.) 

207  to  210.  (a)  Collins  and  Rockwell's  Physiology,  page 
90;  (b)  page  94;  (c)  the  hyoglossi,  styloglossi,  palatoglossi, 
palatopharyngei,  azygos  uvulae,  tensores  palati,  levatores 
palati,  stylopharyngei,  stylohyoids,  geniohyoids,  mylo- 
hyoids, thyrohyoids,  digastrics,  constrictors  of  the  pharynx 
and  the  muscles  of  the  tongue. 


62  PHYSIOLOGY  AND  HYGIENE. 

211.  Give  the  function  of  the  epiglottis.    {January,  1894.) 

211.  The  function  of  the  epiglottis  is  to  cover  the  larynx 
during  deglutition,  and  thus  prevent  food  or  drink  entering 
the  respiratory  tract. 

212.  (a)  Describe  gland  secretion  as  illustrated  hy  the 
action  of  the  parotid  gland.    (March,  1892.) 

213.  State  (b)  the  composition  and  (c)  function  of  saliva, 
{November,  189  4.) 

214-.  (d)  What  influence  has  the  saliva  on  digestion^ 
{September,  1893.) 

215.  (e)  What  would  be  the  effect  on  the  saliva  and  on 
digestion  if  Stenson^s  duct  should  be  divided?  {January, 
1895.) 

212  to  215.  (a)  ^ '  During  and  after  secretion  very  remark- 
able changes  take  place  in  the  cells  lining  the  acini,  which 
are  in  some  way  connected  with  the  production  of  the 
essential  constituents  of  the  salivary  fluids.  In  the  case 
of  the  parotid  gland,  which  may  be  regarded  as  the  type 
of  a  serous  or  albuminous  gland,  the  following  changes  have 
been  observed  by  Langley.  During  the  period  of  rest  and 
just  previous  to  secretory  activity,  the  epithelial  cells  are 
enlarged  and  swollen,  and  encroach  on  the  lumen  of  the 
acinus.  The  protoplasm  of  the  cells  is  so  completely  filled 
with  dark,  fine  granules  as  not  only  to  obscure  the  nucleus, 
but  to  almost  obliterate  the  line  of  union  of  the  cells.  As 
soon  as  secretion  becomes  active,  however,  the  granules 
begin  to  disappear  from  the  outer  region  of  the  cell  and 
move  toward  the  inner  border  and  into  the  lumen  of  the 
acinus.  From  these  observations  it  might  be  inferred  that 
during  rest  the  protoplasm  of  the  cells  gives  rise  to  granular 
material,  and  that  during  and  after  secretory  activity  there 
is  an  absorption  of  new  material  from  the  lymph  and  a 
reconstruction  of  the  granular  material.''  (Brubaker's 
Text-book  of  Physiology.)  And  see  Q.  428  to  431.  (b)  Collins 
and  Rockwell's  Physiology,  page  92;  (c)  page  92;  (d)  page 
93;  (e)  the  saliva  might  be  less  watery  and  the  digestion 


63  PHYSIOLOGY  AND  HYGIENE. 

of  starches  a  little  hindered,  but  the  effects  would  be  very- 
slight  indeed. 

216.  Describe,  by  drawing  or  otherwise,  a  peptic  gland. 
{April,  1895.) 

216.  Collins  and  Rockwell's  Physiology,  page  96. 

217.  Describe  (a)  the  functions  and  (b)  secretions  of  the 
stomach.    {June,  1899.) 

217.  (a)  The  functions  of  the  stomach  are:  (1)  the  recep- 
tion of  the  food;  (2)  the  secretion  of  the  gastric  juice;  (3) 
the  thorough  mixing  of  the  gastric  juice  with  the  food;  (4) 
the  digestion  of  proteids;  and  (5)  the  absorption  of  such 
part  of  the  food  as  is  ready  for  absorption,  (b)  Collins 
and  Rockwell's  Physiology,  pages  97  and  98. 

218.  State  (a)  the  specific  gravity  and  (b)  reaction  of 
gastric  juice,  and  (c)  describe  its  action.    {January,  1894.) 

219.  (d)  Give  the  principal  characteristics  of  gastric  juice 
in  man.     {January,  1897.) 

220.  (e)  What  circumstances  and  conditions  favor  gastric 
digestion?    {May,  1895.) 

221.  (f)  What  are  the  ferments  of  gastric  juice  and  what 
is  the  action  of  each  ferment?    {September,  1897.) 

222.  (g)  Discuss  the  action  of  gastric  juice  on  carbo- 
hydrates and  fats.    {June,  1901.) 

223.  (h)  What  are  the  products  of  gastric  digestion?  (i) 
What  disposition  is  made  of  these  products?  {September, 
1901.) 

224.  (h)  What  are  the  products  of  gastric  digestion?  {Sep- 
tember, 1898.) 

225.  (c),  (d)  What  is  the  physiological  action  of  gastric  juice 
on  food?  (j)  State  the  average  time  occupied  in  gastric 
digestion.     {June,  1902.) 

226.  (k)  What  are  peptones?  How  are  they  formed? 
{May,  1899.) 

227.  (1)  How  does  the  nervous  system  influence  gastric 
digestion?     {September,  1897.) 


64  PHYSIOLOGY  AND  HYGIENE. 

228.  (m)  What  'prevents  digestion  of  the  stomach  hy  its 
own  juice f     {April,  1897.) 

218  to  228.  (a)  Collins  and  Rockwell's  Physiology,  page 
97;  (b)  page  97;  (c)  pages  98  and  99;  (d)  pages  98  and  99; 
(e)  page  100;  (f)  see  below  Table  in  A.  231  to  239  (e);  (g) 
Collins  and  Rockwell's  Physiology,  page  99 ;  (h)  pages  98  and 
99;  (i)  pages  98  and  99;  (j)  page  100;  (k)  pages  98  and  99; 
(1)  page  100.  (m)  '^  Why  the  stomach  or  any  other  portion 
of  the  intestinal  tract  brought  into  contact  with  digestive 
juices  is  not  destroyed  has  given  rise  to  much  discussion. 
Normally,  self-digestion  does  not  occur,  but  if  an  animal 
is  killed  while  in  full  digestion  and  the  body  is  kept  warm, 
the  stomach  will  be  destroyed.  This  has  been  found  to 
take  place  in  human  bodies.  If  a  portion  of  the  stomach 
is  deprived  of  its  blood  supply,  that  portion  will  be  attacked 
and  a  perforation  of  the  stomach  may  result.  The  immunity 
of  the  stomach  to  the  gastric  juice  has  been  explained  in 
a  number  of  ways,  but  not  satisfactorily.  It  has  been  said 
that  the  epithelial  lining  of  the  stomach  prevents  the 
absorption  of  the  gastric  juice,  but  this  explanation  raises 
the  question  why  the  living  epithelial  cells  are  immune. 
The  secretion  of  mucus  forming  a  protective  coating  for  the 
stomach  is  an  inadequate  explanation,  owing  to  the  diffi- 
culty of  conceiving  such  a  means  of  protection  to  be  as 
perfect  as  it  is.  Another  theory,  which  holds  the  alkaline 
blood  to  neutralize  the  acid  of  the  stomach  as  it  is  formed, 
cannot  be  applied  in  the  case  of  the  intestine,  where  the 
digestive  juice  is  alkaline.  An  explanation  is  at  present 
impossible.  All  that  can  be  said  is  that  the  immunity  of 
the  intestinal  tract  is  due  to  the  fact  that  it  is  alive. 
Bernard  introduced  the  hind-leg  of  a  living  frog  into  a  dog's 
stomach  through  a  fistula.  It  was  digested.  But  in  this 
case  the  cells  of  the  frog's  limb  were  first  destroyed  by  the 
acid.  It  has  been  shown  by  Neumeister  that  a  living  frog's 
leg  is  not  digested  by  a  strong  pancreatic  digestive  mixture 
of  weak  alkaline  reaction,  because  in  this  case  the  cells  are 
not  killed."     (Guenther's  Physiology,  page  67.) 


65  PHYSIOLOGY  AND  HYGIENE. 

229.  Describe  the  ^physiology  of  vomiting.     (May,  1896.) 

229.  Collins  and  RockwelPs  Physiology,  page  101. 

230.  What  is  the  reaction  of  (a)  saliva,  (b)  pancreatic 
juice,  (c)  blood?    {January,  1902.) 

230.  (a)  Alkaline;  (b)  alkaline;  (c)  alkaline. 

231.  (a)  What  are  the  functions  of  the  pancreas?  {May, 
1897.) 

232.  Describe  (b)  the  properties  and  (c)  functions  of 
pancreatic  juice.     {April,  1894.) 

233.  Give  (d)  the  composition  and  (c)  the  function  of 
pancreatic  juice.     {June,  1898.) 

234.  (b)  Describe  the  pancreatic  juice,  (e)  mentioning  its 
ferments  and  stating  their  specific  actions.    {April,  1899.) 

235.  (e)  Name  and  give  the  action  of  each  of  the  ferments 
in  pancreatic  juice.     {May,  1896.) 

236.  (e)  State  the  action  of  the  pancreatic  secretion  in  the 
digestion  of  food.     {January,  1896.) 

237.  (e)  What  are  the  uses  of  saliva,  trypsin,  amylopsin? 
{May,  1901.) 

238.  (e)  State  the  function  of  ptyalin,  amylopsin,  pepsin, 
trypsin,  invertin,  steapsin.     {September,  1899.) 

239.  (f)  What  would  be  the  effect  on  digestion  if  the 
pancreatic  duct  were  obstructed?    {May,  1895.) 

231  to  239.  (a)  Collins  and  Rockwell's  Physiology,  pages 
104  to  106;  (b)  pages  104  and  105;  (c)  pages  106  and  105; 
(d)  page  105;  (e)  page  105.  The  following  table  from 
Dunglison's  Medical  Dictionary  will  be  of  use: 


m  PHYSIOLOGY  AND  HYGIENE. 

Table  op  Ferments  Contained  in  the  Digestive  Juices. 


Digestive 
Juices. 


Saliva. 


Gastric  juice. 


Pancreatic  juice. 

Bile. 
Intestinal  juice. 


Ferments  contained 
in  them. 


Salivary  diastase  or 
ptyalin. 

{Pepsin. 
Curdling  ferment. 
Trypsin. 


Curdling  ferment. 
Pancreatic  diastase. 

Emulsive  ferment. 


f  Invertin. 

L  Curdling  ferment. 


Action  as  Food  Materials. 


Changes  starch  into  dextrin 
and  sugar. 

Changes  proteids  into  pep- 
tones in  an  acid  medium. 
Curdles  the  casein  of  milk. 

Changes  proteids  into  pep- 
tones in  alkaline  and  neu- 
tral media. 

Curdles  the  casein  of  milk. 

Changes  starch  into  dextrin 
and  sugar. 

Emulsifies  and  partially 
saponifies  fats. 

Assists  in  emulsifying  fats. 

Changes  cane-sugar  into  in- 
vert sugar. 
Curdles  the  casein  of  milk. 


(f)  Collins  and  Rockwell's  Physiology,  page  106;  there 
would  be  a  decided  diminution  in  the  activity  of  the 
digestion  of  all  kinds  of  foods — particularly  of  proteids  and 
fats;  there  would  be  noticeable  carbohydrate  indigestion, 
and  starch  would  be  abundant  in  the  stools. 

240.    Define    emulsification,    saponification.      Illustrate. 
(June,  190  L) 

240.  Collins  and  Rockwell's  Physiology,  page  105. 

241 .  What  changes  occur  in  the  hlood  in  its  passage  through 
the  liver?     (March,  1892.) 

241.  See  Q.  114. 

242.  What  are  the  functions  of  the  liver?    [April,  1897.) 
24s.  Describe  the  functions  of  the  liver.    (November,  1891.) 


67  PHYSIOLOGY  AND  HYGIENE. 

2J^Jj..  What  is  the  physiological  function  of  the  liver?  {May^ 
1899.) 

242  to  244.  Collins  and  Rockwell's  Physiology,  pages 
106  to  110. 

245.  (a)  Mention  and  describe  in  detail  an  important 
function  of  the  liver  other  than  the  secretion  of  bile.  (January, 
1902.) 

24.6.  Describe  (b)  the  bile  producing  and  (a)  the  glycogenic 
function  of  the  liver.     {January,  1898.) 

2^7.  State  (c)  the  origin,  (d)  nature,  and  (e)  destination  of 
the  glycogen  of  the  liver.    {June,  1900.) 

248.  (f)  What  experiments  have  been  made  to  prove  the 
glycogenic  function  of  the  liver f    {June,  1897.) 

245  to  248.  (a)  Collins  and  Rockwell's  Physiology,  page 
109;  (b)  pages  106  and  109;  (c)  page  110;  (d)  pages  110 
and  109.  (e)  Its  destination  is  the  other  tissues  of  the  body^ 
chiefly  the  muscles,  where  it  is  a  factor  in  the  generating 
of  muscular  activity  and  body  heat,  (f)  Claude  Bernard 
''fed  a  dog  for  seven  days  with  food  containing  a  large 
quantity  of  sugar  and  starch;  and,  as  might  be  expected,, 
found  sugar  in  both  the  portal  and  hepatic  blood.  But 
when  this  dog  was  fed  with  meat  only,  sugar  was  still 
found  in  the  blood  of  the  hepatic  veins.  No  sugar  was 
found  under  a  meat  diet,  in  the  portal  vein,  if  care  were 
taken,  by  applying  a  ligature  on  it  at  the  transverse  fissure^ 
to  prevent  reflux  of  blood  from  the  hepatic  venous  system. 
Bernard  found  sugar  also  in  the  substance  of  the  liver. 
He  also  found  that  a  liver,  removed  from  the  body,  and 
from  which  all  sugar  had  been  completely  washed  away  by 
injecting  a  stream  of  w^ater  through  its  blood-vessels,  after 
the  lapse  of  a  few  hours  contained  sugar  in  abundance." 
(Kirkes'  Physiology.) 

' '  The  chief  experimental  evidences  in  favor  of  the  glyco- 
genic function  of  the  liver  may  be  enumerated  as  follows: 

''1.  The  glycogen  is  most  abundantly  formed  in  the 
liver  cells  when  carbohydrate  food  is  given,  it  is  formed 


68  PHYSIOLOGY  AND  HYGIENE. 

in  only  small  quantity  on  a  liberal  proteid  diet,  and  is 
probably  never  produced  from  fat;  also  the  amount  of 
glycogen  in  the  cells  increases  with  the  time  which  has 
elapsed  after  a  meal  rich  in  carbohydrates. 

"2.  The  glycogen  contained  in  the  liver  cells  is  after 
death  converted  rapidly  into  dextrose,  and  such  an  action 
is  probably  due  to  the  exaggerated  activity  of  the  asphyx- 
iated and  dying  liver  cells. 

'^3.  A  similar  disappearance  of  glycogen  occurs  during 
a  period  of  inanition,  the  amount  which  has  disappeared 
being  proportional  to  the  time  which  has  elapsed,  and 
during  this  period  the  amount  of  circulating  dextrose  is 
kept  up  close  to  the  normal  value.  Hence  the  most 
probable  explanation  is  that  the  blood  is  being  contin- 
uously supplied  with  dextrose  from  the  stored-up  glycogen 
of  the  liver. 

'^4.  The  kidneys  tolerate  only  a  certain  percentage  of 
dextrose  in  the  circulating  blood  and  commence  to  secrete 
urine  containing  dextrose  when  this  low  level  of  about 
two  parts  per  thousand  is  exceeded.  Hence,  did  the  liver 
not  store  up  the  dextrose  in  some  form,  it  would  reach 
the  systemic  circulation,  and  so  the  kidneys,  and  be 
nearly  all  excreted  in  the  urine  and  lost  to  the  body. 
That  this  is  the  true  explanation  of  the  prevention  of 
glycosuria  after  a  carbohydrate  meal  is  perhaps  most 
clearly  demonstrated  by  slowly  injecting  a  strong  solution 
of  glucose  in  whipped  blood,  under  like  conditions,  in  one 
case  into  the  central  end  of  a  mesenteric  vein  and  in  the 
other  into  the  central  end  of  a  systemic  vein,  such  as  the 
jugular.  In  the  former  case,  no  glycosuria  occurs  because 
the  liver  cells  store  up  the  sugar;  but,  in  the  latter  case, 
glycosuria  follows  immediately,  obviously  because  the 
sugar  in  excessive  amount  reaches  the  general  circulation, 
and  so  the  kidneys,  before  it  can  be  taken  up  by  the  liver 
cells. 

^'5.  Direct  analysis  of  the  blood  of  the  portal  and  hepatic 
veins,  (a)  during  carbohydrate  absorption,  and  (5)  during 


69  PHYSIOLOGY  AND  HYGIENE. 

inanition,  have  demonstrated  that  in  the  former  case  the 
blood  passing  to  the  Hver  contains  more  carbohydrate  than 
that  leaving  the  organ,  while  in  the  latter  case  the  reverse 
condition  is  observed.  Here  it  must  be  remarked,  however, 
that  the  blood  supply  to  the  liver  is  so  copious  as  to  render 
the  difference  in  percentage  small  even  when  a  large  trans- 
ference of  material  may  be  taking  place.  Further,  the  rate 
of  removal  of  carbohydrate  from  the  liver  is  never  so  great 
as  the  rate  of  its  storage  during  the  assimilation  of  a  heavy 
carbohydrate  meal,  and  hence,  although  the  differences  in 
percentages  of  portal  and  hepatic  blood  are  sufficient  to 
demonstrate  storage  in  the  liver,  they  are  quite  insufficient 
according  to  many  observers  to  prove  that  this  stored 
carbohydrate  is  again  set  free  as  dextrose. '^  (Reference 
Handbook  of  the  Medical  Sciences). 

.249.  (a)  Where  is  bile  first  formed?  (b)  Trace  its  course 
to  the  intestines.     (April,  1895.) 

250.  (c)  Describe  the  process  of  bile  secretion,  (d)  Mention 
the  functions  of  the  bile.     (January,  1900.) 

251.  (d)  Name  the  functions  of  bile  in  the  intestines. 
(November,  1893.) 

252.  What  is  the  function  in  digestion  of  (e)  saliva,  (d) 
bile?     (September,  1896.) 

253.  (f )  Describe  cholesterin,  giving  its  origin  and  function. 
(September,  1899.) 

25 Jj..  (g)  Name  the  bile  salts  and  (d)  state  the  physiological 
function  of  bile.     (June,  189^.) 

255.  (d)  What  are  the  uses  of  bile?    (November,  1892.) 

256.  (h)  Describe  bile  and  (d)  its  uses,  (i)  Give  a  test 
for  bile.     (June,  1902.) 

249  to  256.  (a)  Bile  is  first  formed  in  the  cells  of  the 
liver,  (b)  From  the  liver  cells  the  bile  passes  into  the  bile 
capillaries,  then  into  one  of  the  two  main  trunks  which 
form  the  hepatic  duct,  then  through  the  hepatic  and  cystic 
ducts  into  the  gall-bladder;  it  may  here  be  stored  up  for 
a   time,   but   eventually  passes   through   the   cystic   and 


70  PHYSIOLOGY  AND  HYGIENE. 

common  bile  ducts  to  enter  the  duodenum  at  the  same 
place  as  the  pancreatic  juice  flows  in  from  the  pancreatic 
duct.  Sometimes  (during  digestion)  the  bile  passes  at  once 
from  the  hepatic  duct  to  the  duodenum,  (c)  Collins  and 
Rockwell's  Physiology,  pages  106  and  109;  (d)  page  109; 
(e)  pages  92  and  93;  (f)  page  109.  '^The  mode  of  origin  of 
cholesterin  in  the  body  has  not  been  clearly  made  out. 
Whether  it  is  formed  in  the  tissues  generally,  in  the  blood, 
or  in  the  liver,  is  not  known;  nor  has  it  been  determined 
conclusively  that  it  is  derived  from  albuminous  or  nervous 
matter.  It  is  also  doubtful  if  we  are  to  regard  it  as  a 
waste  substance  of  no  use  to  the  body,  as  its  presence  in 
the  blood  corpuscles,  in  jiervous  matter,  in  the  egg,  and  in 
vegetable  grains  points  to  a  possible  function  of  a  histo- 
genetic  or  tissue-forming  character."  (McKendrick.)  (g) 
Collins  and  Rockwell's  Physiology,  page  107 ;  (h)  page  107 ; 
(i)  page  108. 

257.  (a)  What  causes  an  increased  flow  of  hile  into  the 
duodenum?  (b)  What  pathological  effects  may^ensue  because 
of  occlusion  of  the  ductus  communis  choledochus?  (June^ 
1900.) 

258,  (c)  How  would  digestion  he  affected  were  the  ductus 
communis  choledochus  obstructed?     {September,  1896.) 

257  and  258.  (a)  An  increased  supply  of  water;  the 
ingestion  of  food,  particularly  during  the  time  of  its 
absorption;  the  absorption  of  bile  or  bile  salts;  certain 
drugs,  called  cholagogues,  such  as  sodium  salicylate  and 
benzoate,  colchicum,  aloes,  jalap,  podophyllin,  rhubarb, 
colocynth,  etc.  (b)  Jaundice,  gastrointestinal  indigestion, 
hepatic  colic,  pruritus,  enlargement  of  gall-bladder,  hyper- 
trophy of  liver  with  possible  subsequent  atrophy,  hemor- 
rhage, bodily  weakness  and  loss  of  weight,  and  finally  death, 
(c)  Owing  to  the  consequent  loss  of  bile  to  the  intestinal 
contents,  fermentation  and  putrefaction  are  much  increased ; 
emulsification  of  fats  is  considerably  impaired.  From 
irritation  set  up  by  excessive  putrefaction,  peristalsis  may 
become  much  accelerated,  causing  diarrhoea 


71  PHYSIOLOGY  AND  HYGIENE. 

259.  What  substances  are  absorbed  principally  in  (a)  the 
stomach,  (b)  the  duodenum?    (May,  1897.) 

259.  (a)  Alcohol  chiefly;  peptones,  sugars,  and  salts  to 
a  limited  extent;  water  very  slightly,  and  fats  not  at  all. 
Absorption  in  the  stomach  is  aided  by  alcoholics  and 
condiments,  (b)  Nearly  all  products  of  digestion;  water, 
proteoses,  peptones,  sugars,  soaps,  salts. 

260.  Describe  the  vermicular  movement  of  (a)  the  stomach 
and  (b)  intestines,  (c)  What  purpose  does  this  movement 
serve?    {May,  1900.) 

261.  Describe  the  peristaltic  action  of  (a)  the  stomach  and 
of  (b)  the  intestines.     {June,  1894.) 

262.  (b)  Describe  the  peristaltic  movement  of  the  intestines. 
(April,  1897.) 

263.  (a),  (b)  Describe  peristalsis  and  state  where  it  occurs. 
{April,  1893.) 

264'  (a),  (b)  Describe  peristaltic  movement.  {November, 
1892.) 

265.  (b)  Describe  the  physiological  operation  of  peristalsis 
in  the  small  intestine.     {November,  1894.) 

266.  (d)  Define  peristalsis,  (e)  In  what  conditions  is 
peristaltic  action  reversed?    {September,  1901.) 

260  to  266.  (a)  Collins  and  Rockwell's  Physiology,  pages 
99  and  100,  and  see  (d) ;  (b)  Collins  and  Rockwell's  Physi- 
ology, pages  101  and  102,  and  see  (d) ;  (c)  Collins  and  Rock- 
well's Physiology,  pages  100  and  102.  (d)  Peristalsis  is 
' '  a  kind  of  undulation  or  vermicular  movement,  induced  by 
contraction  of  the  circular  muscular  fibres  of  the  intestine 
from  above  downward.  The  purpose  of  this  successive 
contraction  of  the  circular  fibres  is  to  propel  the  intestinal 
contents.  When  the  fibres  contract  inversely  they  occasion 
an  antiperistaltic  action.  Peristaltic  action  is  involuntary, 
and  is  not  under  the  immediate  influence  of  either  brain 
or  spinal  marrow.  It  continues  for  some  time  after  death." 
(Dunglison's  Medical  Dictionary.)  (e)  Peristaltic  action  is 
reversed  in  vomiting,  in  cases  of  hernia,  and  intestinal 


72  PHYSIOLOGY  AND  HYGIENE. 

obstruction;   also  when   the   rectum  is   not   emptied  its 
contents  are  carried  upward  into  the  sigmoid  flexure. 

267.  Where  are  the  valvulce  conniventesf  State  how  they 
are  formed  and  give  their  function.     (January,  1902.) 

267.  Collins  and  Rockwell's  Physiology,  pages  102,  111 
and  112. 

268.  (a)  What  digestive  changes  take  place  in  the  small 
intestine?     (September,  1902.) 

269.  (a)  Mention  the  digestive  changes  that  take  place  in 
the  small  intestine,  (b)  Give  the  physiology  of  rectal  feeding, 
(May,  1898.) 

268  and  269.  (a)  Collins  and  Rockwell's  Physiology, 
pages  104,  105,  106  and  109;  (b)  page  110;  and  see  Q.  304 
and  305. 

270.  (a)  Describe  the  structure  of  an  intestinal  villus  and 
show  how  it  is  adapted  for  absorption.    (April,  1893.) 

271.  Describe  (b)  the  glands  and  (a)  the  villi  of  the  intes- 
tines.    (June,  1898.) 

270  and  271.  (a)  Collins  and  Rockwell's  Physiology, 
page  112;  (b)  pages  102  to  104  and  112. 

272.  Describe  the  ileoccecal  function.    (January,  1894.) 

272.  The  function  of  the  ileocsecal  valve  is  to  prevent 
the  contents  of  the  large  intestine  from  passing  back  again 
into  the  small  intestine;  it  is  also  a  barrier  against  the 
passage  upward  of  the  bacteria  which  are  normally  found 
in  the  large  intestine. 

273.  State  the  physiological  uses  of  the  large  intestine. 
(April,  1899.) 

273.  The  physiological  uses  of  the  large  intestine  are 
(1)  for  absorption;  (2)  formation  of  fecal  matter  from  the 
residue  of  its  contents  after  the  absorption  of  the  nutritious 
parts;  and  see  Collins  and  Rockwell's  Physiology,  pages 
110  and  111. 

271}..  What  digestive  changes  take  place  in  (a)  the  small 
intestines,  (b)  the  large  intestine?    (January,  1901.) 


73  PHYSIOLOGY  AND  HYGIENE. 

275.  (b)  Give  a  summary  of  the  digestive  changes  in  the 
large  intestine.     (April,  1895.) 

276.  (b)  What  digestive  changes  occur  in  the  large  intestine? 
{September,  1896.) 

274  to  276.  (a)  Collins  and  Rockwell's  Physiology,  pages 
101  to  110;  (b)  page  110. 

277.  Give  the  junction  of  (a)  gastric  juice,  (b)  synovial 
fluid,  (c)  succus  entericus.     (January,  1899.) 

277.  (a)  Collins  and  Rockwell's  Physiology,  page  98. 
(b)  To  lubricate  the  joints  and  also  to  prevent  friction 
between  the  tendons  and  their  sheaths,  (c)  "It  has  no 
influence  on  proteids  and  fats,  but  may  convert  starches  to 
maltose  and  dextrin,  invert  cane-sugar  to  dextrose  and 
levulose,  and  change  maltose  to  dextrose."  (Guenther's 
Physiology.) 

278.  Oj  ivhat  are  the  common  and  expected  contents  oj  the 
appendix  vermijormis  composed,  whether  jound  on  the  dissect- 
ing table,  or  in  surgical  operations  involving  that  structure? 
(January,  1895.) 

278.  The  ordinary  contents  of  the  appendix  are:  mucus, 
fecal  matter,  or  concretions,  lymphoid  tissue,  pus,  and 
rarely  a  foreign  body. 

279.  Discuss  bacteria  in  the  intestines.  (May,  1895.) 
279.  "Certain  changes  take  place  in  the  intestinal  con- 
tents independent  of,  or  at  any  rate  supplemental  to,  the 
action  of  the  digestive  ferments.  These  changes  are 
brought  about  by  the  action  of  micro-organisms  or  bacteria 
.  .  .  .  Many  forms  of  bacteria  have  been  isolated  from 
the  mouth,  a  few  varieties  from  the  stomach,  and  a  very 
large  number  from  the  intestines.  It  is  only  in  the  last- 
named  locality  that  their  multiplication  has  much  effect 
from  a  physiological  point  of  view.  In  the  intestinal  canal 
it  appears  that  certain  changes  occur  which  are  distinctly 
due  to  micro-organisms;  these  changes  are  possibly  kept 
within  limits  by  the  presence  of  bile  in  the  intestine.    The 


74  PHYSIOLOGY  AND  HYGIENE. 

changes  said  to  be  due  under  ordinary  circumstances  are  as 
follows:  (1)  The  formation  of  indol,  skatol,  cresol  and 
phenol,  chiefly  from  peptone  (?  antipeptone)  in  the  small 
intestine,  and  possibly  in  the  large  intestine  also.  These 
substances  are  absorbed  and  excreted  in  the  urine  as 
combined  sulphates.  In  addition  to  these,  as  results  of 
decomposition  of  albuminous  substances,  there  are  many 
other  products — e.  g.,  gases,  such  as  ammonia,  sulphuretted 
hydrogen,  volatile  and  fatty  acids,  leucin  and  tyrosin, 
phenylacetic,  phenylpropionic,  and  other  acids.  (2)  The 
formation  of  lactic  acid  and  butyric  acid  from  carbohydrates. 
This  occurs  in  two  stages,  and  chiefly  results  from  decom- 
position of  sugars.  (3)  The  decomposition  of  cellulose 
(CeHipOs-l-HaO^SCO^+SCHJ.''  (Kirkes'  Handbook  of 
Physiology.) 

280.  (a)  In  a  healthy  man,  what  time  is  consumed  in  the 
digestion  of  an  ordinary  meal  of  meat,  vegetables,  and  bread? 
(b)  Describe  the  digestion  of  meat.    (June,  1896.) 

280.  (a)  Coflins  and  Rockwell's  Physiology,  page  100;  (b) 
pages  98,  99,  105,  and  Egbert's  Hygiene  and  Sanitation, 
pages  221  to  226. 

281.  Give  the  successive  steps  in  the  digestion  of  a  meal 
of  roast  beef  and  potatoes.    (January,  1898.) 

282.  Describe  the  digestion  of  a  meal  of  beefsteak  and 
potatoes.     (May,  1894.) 

283.  Describe  the  digestion  of  a  meal  consisting  of  roast 
beef  (with  an  excess  of  fat)  and  potatoes.    (April,  1897.) 

284'  Gi'^''^  the  process  of  the  digestion  of  milk.  (January, 
1894.) 

285.  Describe  the  digestion  in  the  stomach  of  a  meal  of 
bread  and  milk.     (March,  1893.) 

286.  Describe  in  detail  the  digestion  of  a  meal  consisting 
of  bacon,  eggs,  and  toasted  bread.    (May,  1901.) 

287.  Mention  three  examples  of  amyloid  food.  Describe 
in  detail  the  changes  that  amyloid  food  undergoes  in  the 
process  of  digestion,     (September,  1902.) 


75  PHYSIOLOGY  AND  HYGIENE. 

288.  Describe  the  digestion  and  absorption  of  a  meal  of 
eggs  and  beef.     (November,  1894.) 

281  to  288.  Collins  and  Rockwell's  Physiology,  pages 
28,  29,  and  98  to  110;  and  Egbert's  Hygiene  and  Sanitation, 
pages  217  to  225. 

2.    Absorption. 

289.  (a)  What  do  you  understand  by  absorption?  (July, 
1893.) 

290.  (b)  What  are  the  channels  of  absorption?     {Aprily 

1894.) 

291.  Describe  the  process  of  absorption  by  (c)  the  blood- 
vessels, (d)  the  lymphatics.     (June,  1901.) 

292.  (e)  How  do  the  products  of  digestion  find  their  way 
into  the  blood?     (January,  1901.) 

293.  (e)  How  do  the  products  of  digestion  enter  the  circu- 
lation?     (July,  1893.) 

294'  (g)  How  does  the  digested  food  enter  the  circulation 
of  the  blood?     (November,  1891.) 

295.  (f)  Describe  the  relative  activity  of  absorption  in  the 
alimentary  canal,  the  skin,  and  the  lungs.     (May,  1895.) 

289  to  295.  (a)  Collins  and  Rockwell's  Physiology,  page 
111;  (b)  page  111;  (c)  page  114;  (d)  page  113;  (e)  pages 
113  and  114.  ''Physiological  experiments  have  demon- 
strated that  the  agents  concerned  in  the  removal  of  the 
products  of  digestion  after  their  absorption  from  the 
interior  of  the  villus  are:  (1)  The  bloodvessels  of  the 
gastrointestinal  tract,  which  unite  to  form  the  portal  vein. 
(2)  The  lymph  vessels  of  the  small  intestine,  which  con- 
verge to  empty  into  the  thoracic  duct.  The  products  of 
digestion  find  their  way  into  the  general  circulation  by 
these  two  routes,  as  follows:  The  water,  inorganic  salts, 
proteids,  and  sugar  after  entering  the  blood-vessels  of  the 
villus  are  carried  by  the  blood  directly  into  the  liver  by 
the  portal  vein;  after  circulating  through  the  capillaries  of 
the  liver  and  being  influenced  by  the  liver  cells,  they  are 


76  PHYSIOLOGY  AND  HYGIENE. 

discharged  by  the  hepatic  veins  into  the  ascending  vena 
cava.  The  fats  after  entering  the  lymph  radicle  of  the 
villus  are  carried  by  the  lymph  stream  into  the  thoracic 
duct,  by  which  they  are  poured  into  the  blood  at  the 
junction  of  the  left  subclavian  and  internal  jugular  veins.'' 
(Brubaker's  Text-hook  of  Physiology.)  (f)  (1)  ''The  greatest 
activity  of  absorption  occurs  in  the  alimentary  canal.  In 
it  the  materials  of  the  duly  digested  food  find  their  way 
by  means  of  this  process  on  the  one  hand  into  the  blood- 
vessels of  the  portal  circulation,  and  on  the  other  into  the 
lacteal  vessels,  which  are  the  commencements  of  the 
lymphatic  vessels  of  the  intestines.  (2)  When  simply  left" 
in  contact  with  the  skin,  substances,  unless  in  a  fluid  state, 
are  seldom  absorbed.  Metallic  preparations  and  vegetable 
matters,  if  soluble  or  already  in  solution,  are  absorbed  if 
rubbed  into  the  skin.  The  effect  of  the  rubbing  is  probably 
to  convey  the  particles  of  the  matter  into  the  orifices  of 
the  glands,  whence  they  are  more  readily  absorbed  than 
they  would  be^  through  the  epidermis.  (3)  It  is  a  remark- 
able fact  that  not  only  is  the  epithelium  of  the  pulmonary 
air  vesicles  able  to  allow  the  passage  through  it  of  gases 
and  volatile  substances,  but  that  also  under  certain  con- 
ditions fluids  such  as  water  may  also  be  absorbed,  and 
besides  this,  the  presence  of  carbon  particles  in  the  bron- 
chial glands  and  elsewhere  in  connection  with  the  lungs 
must  point  to  the  pulmonary  epithelium  as  the  only  possible 
channel  of  their  absorption."  (Kirkes'  Handbook  of  Physi- 
ology.) 

296.  (a)  Mention  the  different  digestive  fluids  and  state 
the  function  of  each.     {June,  1897.) 

297.  (a)  Name  the  digestive  fluids  with  which  the  food  is 
brought  in  contact  in  its  passage  through  the  alimentary  canal. 
(June,  1893.) 

298.  (b)  Mention  the  enzymes  of  the  digestive  system  and 
state  the  peculiar  function  of  each.     {June,  1902.) 

299.  (a)  Name  the  severed  digestive  ferments  and  give  the 
action  of  each.     {November,  1891.) 


77 


PHYSIOLOGY  AND  HYGIENE. 


300.  (a)  Name  the  ferments  that  are  the  essential  con- 
stituents of  each  digestive  fluid.    (June,  1895.) 

296  to  300.  (a)  See  Table  in  A.  231  to  239  (e);  (b) 

Table  of  Enzymes. 


DiASTATIC  OR 
AMYLOLYTI C 
FERMENTS. 


Invbrsivb 

ferments. 


'  Which   convert  starch  and  ^ 
amyloids  into  maltose.        ' 


Which  convert  maltose  into 
glucose. 


'  Which  convert   cane-sugar 
into   dextrose  and  leva-  - 
lose. 


Which    decompose    gluco- 
sides. 


Decomposing  sugar. 
Decomposing  fats. 


Proteolytic   f  Which  decompose  proteids 
FERMENTS.     \      and  form  peptones. 


Diastase  from  malt. 

Ptyalin  from  saliva. 

Amylopsin  from  pan- 
creas. 

Other  ferments  having 
a  similar  action  from 
other  parts  of  the 
body. 

From  small  intestine. 

Invertin  from  the  intes- 
tinal juice. 

Invertin  from  the  mucus 
of  the  mouth. 

Invertin  from  the  tissue 
of  the  testis. 

Emulsin  from  bitter  al- 
monds. 
Myrosin  from  mustard. 

Rennet. 

From  stomach. 
From    pancreas  (Sfcea- 
topsin). 

Pepsin  from  stomach. 
Trypsin  from  pancreas. 
Others  from  saliva. 
Histozvme. 


(From  Dunglison's  Medical  Dictionary.) 

301.  (a)  Give  the  composition  of  normal  feces.  (November, 
1893.) 

302.  (b)  State  the  average  weight  of  feces  in  twenty-four 
hours  in  a  normal  man.  (c)  What  proportion  is  made  up 
of  -fluid  and  what  of  solid  contents?    (November,  1894.) 


78 


PHYSIOLOGY  AND  HYGIENE. 


303.  (d)  Give  the  muscular  and  nervous  mechanism  of 
defecation.     (September,  1895.) 
301  to  303.  (a) 

Composition  of  Feces. 


Gases. 

Liquids. 

Solids: 

Undigested  Food. 
Indigestible  Matter. 

Bacteria  and  the 
Resins. 


Bile  Residues. 
Excretin. 
Inorganic  Salts. 


N,  H,  COj,  H^S,  CH4. 

HjO  (68  %  to  82  %  normally). 

Fats,  fragments  of  meat,  starch. 

Cellulose,   ligaments  from  meat,   keratin, 
mucin,  gums. 

Products  of  their  decomposition  of  foods: 
lower  fatty  acids,  lactic  acid,  tyrosin  and 
its  decomposition  products,   phenol, 
hsematin,  insoluble  soaps  of  Ca  and  Mg. 

Mucus,  cholesterin,  biliary  acids,  stercobilin. 

CtsHissSO^ 

Soluble  salts  of  Na,  K,    Mg,  etc. 

Insoluble  salts  of  Ca,  Mg,  Fe,  etc. 


(From  Hall's  Text-hook  of  Physiology,  p.  340.) 

(b)  About  eight  ounces;  (c)  fluid  about  75  per  cent.,  solid 
about  25  per  cent. ;  (d)  Collins  and  Rockwell's  Physiology^ 
page  110. 

304.  Describe  the  physiology  of  rectal  feeding.  (May^ 
1894.) 

305.  What  physiological  laws  are  the  basis  of  rectal  feeding 
in  disease?     (September,  1893.) 

304  and  305.  ''That  all  mucous  membranes  are  capable 
of  absorbing  certain  materials  from  their  surfaces  and 
passing  them  into  the  bloodvessels  or  lymphatics  has  long 
been  recognized;  but  it  is  only  of  comparatively  recent 
years  that  this  knowledge  has  been  applied  extensively  to 
the  purpose  of  nourishing  patients  by  means  of  the  rectum^ 
and  the  fact  is  now  established  that  sufficient  aliment  may 


79  PHYSIOLOGY  AND  HYGIENE. 

be  absorbed  from  the  mucous  membrane  of  the  rectum  or 
sigmoid  flexure  alone  to  sustain  Ufe  for  a  considerable 
period,  amounting  in  some  cases  from  four  to  seven  weeks. 
Moreover,  the  rectum  may  be  utilized  for  accessory  feeding 
for  manj^  cases  in  which  the  stomach  is  able  to  digest  some 
food,  but  not  in  sufficient  quantity  to  prevent  emaciation. 
Whenever  rectal  food  enemata  are  employed  certain  prin- 
ciples should  be  observed:  (1)  The  rectal  surface  must 
be  cleansed  from  all  mucus  and  feces.  (2)  The  irritation 
of  the  rectum  should  be  allayed  as  far  as  possible.  (3)  The 
quantity  and  quality  of  food  thus  administered  should  be 
so  regulated  as  to  avoid  exciting  peristalsis,  and  yet  allow 
of  the  complete  absorption  of  one  injection  before  another 
is  given.''     (Thompson's  Practical  Dietetics.) 

3.  The  Lymphatic  System. 

306.  (a)  Describe  the  lymphatic  system.    (May,  1898.) 

307.  (a)  Describe  the  lymphatic  system.  {September , 
1896.) 

308.  (a)  Describe  the  lymphatic  circulation  and  (b)  name 
the  forces  by  which  the  current  of  lymph  is  kept  up.  (January ^ 
1896.) 

309.  (b)  What  agencies  induce  the  flow  of  lymph  to  the 
point  of  discharge  in  the  veins?    (April,  1895.) 

310.  (b)  What  agencies  cause  the  lymph  to  flow  toward 
the  point  of  its  discharge  in  the  body?    (September,  1898.) 

311.  (c)  Describe  the  flow  of  lymph.    (June,  1898.) 

312.  (c)  Give  the  course  of  a  lymph  corpuscle  to  its  deposit 
in  the  circulation.     (June,  1895.) 

306  to  312.  (a)  Collins  and  Rockwell's  Physiology,  pages 
70  to  75;  (b)  page  73;  (c)  pages  72  and  73. 

313.  (a)  Describe  lymph  and  (b)  state  its  uses.  (May, 
1899.) 

314.  Give  (c)  the  origin  and  (b)  uses  of  lymph.  (June^ 
1896.) 


80 


PHYSIOLOGY  AND  HYGIENE. 


315.  State  (c)  the  source  and  (b)  the  uses  of  lymph.    (Janu- 
ary, 1897.) 

313  to  315.  (a)  Collins  and  Rockwell's  Physiology,  page 
46;  (b)  page  47;  (c)  page  47. 

316.  State  the  origin  and  the  uses  of  (a)  the  lymph,  (b)  the 
hile.     (September,  1900.) 

316.  (a)  See  Q.  314;  (b)  Collins  and  Rockwell's  Physi- 
ology, pages  106  and  109. 

317.  Give  (a)  the  properties  and  (b)  composition  of  lymph 
and  of  chyle.     (April,  1896.) 

318.  (a),  (b)  State  the  difference  between  chyle  and  lymph. 
(September,  1892.) 

319.  (a)  Describe  the  physical  properties  of  lymph  and 
chyle.     (May,  1901.) 

317  to  319.  (a)  Collins  and  Rockwell's  Physiology,  pages 
46  and  47;  (b) 


Lymph. 

Chyle. 

Water 

95.0 

90.5 

Solids 

5.0 

9.5 

Fibrin 

0.1 

0.1 

Proteids 

4.1 

7.0 

Fat,  etc.  .      .      .      . 

traces 

1.0 

Extractives 

0.3 

} 

1.4 

Salts 

0.5 

(Compiled  from  Chapman's  Human  Physiology.) 

320.  Describe  (a)  chyme,  (b)  chyle.  (April,  1898.) 
320.  (a)  ''Chyme  is  the  grayish,  thick,  acid  liquid,  into 
which  the  food  is  transformed  by  gastric  digestion.  It 
consists  of  a  solution  of  proteids  and  salts  containing 
liquefied  fat  and  suspended  particles  and  lumps  of  undi- 
gested matter."  (Duane's  Medical  Dictionary.)  (b)  See 
Q.  317  to  319. 


81  PHYSIOLOGY  AND  HYGIENE. 

321.  What  are  the  junctions  of  the  lymphatic  vessels  and 
glands?    (November,  1892.) 

321.  Collins  and  Rockwell's  Physiology,  pages  70  and  73. 

4.  Foods. 

322.  (a)  Into  what  general  classes  are  foods  divided,  and 
(b)  give  examples  of  each  class  f    (November,  1891.) 

323.  (a)  Make  a  division,  arbitrary  or  otherwise,  of  food- 
stuffs, (b)  giving  an  example  of  each  variety.    (April,  1898.) 

324.  (c)  Name  eight  principal  carbohydrates  used  for  food. 
(November,  1894.) 

325.  What  are  (d)  amyloid  foods,  (e)  proteid  foods?   Give 
three  examples  of  each.     (June,  1895.) 

322  to  325.  (a)  Foods  may  be  classified  as  follows: 

T    T  .    r  Salts. 

I.  Inorganic  I  ^^^^^ 

f  Proteids. 
II.  Organic     i  Carbohydrates. 
I  Fats. 

See  also  Egbert's  Hygiene  and  Sanitation,  pages  215  to 
217.  (b)  Examples  of:  Salts:  Sodium  chloride  and  carbo- 
nate. Proteids:  Flesh  of  animals,  milk,  peas,  beans.  Fats: 
Fat  of  meat,  nuts,  grains.  Carbohydrates:  Sugar,  fruits, 
milk,  cereals,  malt,  bread,  green  vegetables,  sweets,  (c) 
See  (b).  (d)  Amyloid  foods  are  foods  containing  amyloses 
or  starches;  examples :  cereals,  pototoes,  bread,  (e)  Egbert's 
Hygiene  and  Sanitation,  page  217;  for  examples  see  (b). 

326.  Mention  four  alimentary  principles  essential  to  health. 
(September,  1902.) 

326.  Collins  and  Rockwell's  Physiology,  pages  28  and  29; 
and  Egbert's  Hygiene  and  Sanitation,  page  217. 

327.  What  are  the  objects  of  cooking  food?     (November, 
1891.) 

328.  What  changes  in  food  are  effected  by  cooking?    (May, 
1900.) 


82  PHYSIOLOGY  AND  HYGIENE. 

329.  Discuss  the  effect  of  the  cooking  of  food  as  a  means 
of  rendering  it  more  digestible.    (April,  1895.) 

330.  What  purpose  is  served  in  boiling  starchy  food-stuffs? 
Explain.     (May,  1901.) 

327  to  330.  Egbert's  Hygiene  and  Sanitation,  page  226. 

331.  What  precautions  should  be  taken  in  the  ingestion  of 
vegetable  foods?  Give  reasons  for  taking  these  precautions. 
(September,  1894.) 

331.  Egbert's  Hygiene  and  Sanitation,  page  255;  vege- 
tables eaten  raw  should  be  very  thoroughly  washed,  and 
care  taken  to  prevent  the  possibility  of  ingesting  parasites 
(or  their  ova)  or  typhoid  germs. 

332.  Give  (a)  the  relative  food  value  and  (b)  ease  of  diges- 
tion of  meat,  milk,  eggs,  leguminous  fruits.  (September, 
1895.) 

332.  (a)  Leguminous  fruits,  eggs,  meat,  milk;  (b)  milk, 
eggs,  meat,  leguminous  fruits. 

333.  What  fruits  are  preferable  in  cases  of  habitual  consti- 
pation?    (January,  1899.) 

333.  Figs,  prunes,  fresh  apples,  berries,  plums,  shaddock, 
oranges. 

334.  (a)  Discuss  the  dietetic  value  of  alcohol.  (June, 
1901.) 

335.  (a)  Does  alcohol  possess  a  food  action?  On  what  do 
you  base  your  ansiver?     (June,  1894.) 

336.  (b)  Describe  the  physiological  action  of  alcohol.  (May, 
1894.) 

334  to  336.  (a)  Egbert's  Hygiene  and  Sanitation,  pages 
262  to  265.  (b)  Nervous  system:  Alcohol  is  first  a  powerful 
excitant,  afterward  a  depressant;  it  increases  the  reflex 
activity  of  spinal  cord,  muscles,  and  nerves;  in  large  doses 
it  produces  lack  of  co-ordination.  Circulatory  system:  It 
stimulates  the  heart  muscle  and  increases  the  rapidity  and 
force  of  the  heart  beat;  there  is  a  rise  of  arterial  pressure. 
Respiration  is  stimulated  by  small  doses,  and  decreased  by 


83  PHYSIOLOGY  AND  HYGIENE, 

large  ones.  Temperature:  Alcohol  produces  a  sensation  of 
warmth,  and  warms  the  extremities  by  causing  the  heart 
to  pump  hot  blood  from  the  centre  of  the  body  to  the  cold 
parts.  If  used  in  excess  the  temperature  rapidly  falls  owing 
to  increase  of  heat  radiation  and  to  depression  of  vital 
power.  Bodily  metabolism:  Elimination  of  CO2  is  generally 
increased;  the  effect  on  absorption  of  0  is  not  known.  It 
adds  force  but  not  tissue  to  the  body.  Elimination:  It  is 
largely  burnt  up  in  the  body;  but  in  excessive  doses  it  is 
eliminated  by  the  breath,  skin,  kidneys  and  intestines. 
Digestion  is  aided  by  moderate  doses,  but  is  disordered  by 
large  amounts.     (From  Hare's  Therapeutics.) 

337.  What  special  use  does  each  of  the  following  serve  in 
the  body  after  ingestion:  (a)  proteids,  (a)  fats,  (a)  carbo- 
hydrates, (b)  alcohol,  (c)  tea  and  (c)  coffee?    {May,  1900.) 

338.  (a)  What  is  the  function  of  each  class  of  foods  in  the 
nutritive  process?    (September,  1900.) 

337  and  338.  (a)  Egbert's  Hygiene  and  Sanitation,  page 
217;  (b)  pages  262  to  265;  (c)  pages  260  and  261. 

339.  What  is  the  influence  of  diet  on  nutrition?  (June^ 
1894.) 

339.  Collins  and  Rockwell's  Physiology,  pages  136  to  140. 

340.  What  is  the  composition  of  human  milk?  {July,  1893.) 

340.  Collins  and  Rockwell's  Physiology,  page  120. 

341 .  What  precautions  are  necessary  in  the  artificial  feeding 
of  infants?     {January,  1892.) 

341.  Milk  should  be  of  good  quality,  preferably  ''cer- 
tified." It  should  be' used  raw ;  neither  boiled  nor,  if  possible 
to  avoid,  Pasteurized.  It  should  be  so  manipulated,  by 
creaming  and  dilution  with  boiled  water,  with  the  addition 
of  milk-sugar,  as  to  resemble  as  nearly  as  may  be  himaan 
milk.  It  is  well,  as  a  preliminary,  to  start  with  percentages 
well  within  the  digestive  capacity  of  the  child  and  gradually 
to  increase  them,  keeping  watch  on  the  stools  for  evidence 
of  overfeeding,  and  upon  the  weight  for  signs  of  under- 
jeeding. 


84  PHYSIOLOGY  AND  HYGIENE. 

342.  What  is  milk  sterilization  and  how  is  it  performed? 
(September,  1898.) 

342.  '^Sterilization  of  milk  requires  continuous  heating 
under  pressure  for  about  two  hours  at  248°  F.,  at  which 
temperature  not  alone  the  bacteria  and  their  spores  are 
destroyed,  but  the  normal  appearance  and  taste  of  the 
milk  as  well.  Part  of  the  sugar  is  converted  to  caramel, 
part  of  the  casein  is  precipitated,  and  the  milk  will  no 
longer  form  a  cohesive  coagulum  with  rennet. '^  (Harring- 
ton's Practical  Hygiene.) 

343.  Give  the  comparative  nutritive  value  of  sterilized  and 
of  unsterilized  cows^  milk.    {January,  1897.) 

343.  Unsterilized  milk  has  a  greater  nutritive  value  than 
sterilized  milk. 

344'  What  in  your  judgment  is  the  best  method  of  prep- 
aration of  artificial  food  for  infants?  Why?  {November, 
1893.) 

344.  Authorities  are  generally  agreed  that  some  modi- 
fication of  cows'  milk  is  the  most  practical,  useful,  and 
reliable.  The  following  "low  average"  is  suggested  for  a 
healthy  infant :  Fat,  3  per  cent. ;  sugar,  6  per  cent. ;  pro- 
teid,  1  per  cent.     It  can  be  approximated  by  taking — 

Top  milk  (after  six  hours)  from  a  quart  bottle    .  10  ozs. 

Boiled  water .  30   " 

Milk-sugar,  by  weight  (about  8  teaspoonfuls) .      .       2    " 
Salt a  pinch. 

Two  to  4  ounces  of  the  water  may  at  times,  with  advan- 
tage, be  replaced  by  an  equal  quantity  of  lime-water  or 
strained  barley-water. 

345.  How  would  you  prepare  an  artificial  food  for  a 
newborn  infant?     {March,  1893.) 

345.  For  the  first  twenty-four  hours  give  simply  5  per 
cent,  solution  of  lactose.    Thereafter  a  formula  of 


85  PHYSIOLOGY  AND  HYGIENE. 

Fats 2  per  ct. 

Sugar 4.5    '' 

Proteid 0.5     " 

might  be  tried,  compounded  as  follows :  Let  bottle  stand 
six  hours. 

Take  top  milk  (of  quart  bottle) 1  pint. 

Boiled  water 3  pints. 

To  every  10  ounces  of  this  dilution  add  2  teaspoonfuls  of 
lactose,  warm,  and  feed  1  ounce  every  two  hours.  Pre- 
pare fresh  every  day.     Keep  on  ice. 

346.  Prescribe  the  diet  of  a  child  about  ceasing  to  nurse  at 
the  mother's  breast.     (September,  1896.) 
346.  Starr  gives  the  following: 

Cream 1  tablespoonful    (f^ss). 

Milk 11  tablespoonfuls  (f^vss). 

Milk-sugar 1  teaspoonful         (5J)- 

Salt a  pinch. 

Water 4  tablespoonfuls  (f^ij). 

3Jf.7.  What  class  of  foods  should  be  given  to  children  between 
the  first  and  second  year  of  age?    {November,  1892.) 

348.  How  should  an  infant  be  fed  between  the  ninth  and 
twenty-fourth  month?     (April,  1893.) 

349.  What  should  be  the  diet  of  a  child  over  two  years  of 
age?     (January,  1893.) 

347  to  349.  ''The  following  is  a  sample  diet  given  by 
Holt  for  a  child  eighteen  months  old:  First  Meal. — A 
tablespoonful  of  some  cereal  with  salt  and  one  table- 
spoonful  of  cream,  one-half  pint  of  milk.  Second  Meal. — 
One-half  pint  of  milk.  Third  Meal. — One  tablespoonful  of 
scraped  meat,  two  small  pieces  of  dried  bread,  half  a  pint 
of  milk.  Fourth  MeaL— Milk.  Fifth  Meal.—W\\k.  with 
farina  or  arrowroot.  Instead  of  scraped  meat,  beef-juice 
or  a  soft-cooked  egg  may  be  substituted  occasionally.    Of 


10 


86  PHYSIOLOGY  AND  HYGIENE. 

the  beef -juice  from  one  to  three  tablespoonfuls  may  be 
given  at  a  time.  ''The  quantity  of  milk  allowed  at  a  single 
feeding  for  a  child  during  the  second  year  should  be  from 
eight  to  ten  ounces  during  the  first  half  and  from  ten  to 
twelve  ounces  during  the  latter  half  of  the  year"  (Holt). 

"Diet  from  the  Eighteenth  to  the  Thirtieth  Month  (Starr), 
7  A.M.,  new  milk,  eight  ounces;  the  yolk  of  an  egg  lightly 
boiled;  two  thin  slices  of  bread  and  butter,  or  else  milk^ 
and  two  tablespoonfuls  of  well-cooked  oatmeal  or  wheaten 
grits,  with  sugar  and  cream.  11  a.m.,  milk,  six  ounces^ 
with  a  soda  biscuit  or  bread  and  butter.  2  p.m.,  one  table- 
spoonful  of  rare  mutton  pounded  to  a  paste,  bread  and 
butter,  or  mashed  potatoes  moistened  with  good  dish 
gravy,  a  saucer  of  junket;  or  else  a  breakf astcupful  of  beef- 
tea  or  mutton  or  chicken  broth,  a  thin  slice  of  stale  bread, 
a  saucer  of  rice  and  milk  pudding.  6.30  p.m.,  a  breakfast- 
cupful  of  milk  with  bread  and  butter,  or  soft  milk  toast.'' 

' '  Diet  from  Two  and  a  Half  to  Three  and  a  Half  Years  of 
Age — i.  e.,  for  Children  who  have  Cut  their  Milk  Teeth 
(Starr).  7  a.m.,  one  or  two  tumblers  of  milk,  a  saucer  of 
thoroughly  cooked  oatmeal  or  wheaten  grits,  a  slice  of 
bread  and  butter.  11  a.m.  (if  hungry),  a  tumbler  of  milk 
or  a  teacupful  of  beef-tea  with  a  biscuit.  2  p.m.,  a  slice 
of  underdone  roast  beef  or  mutton,  or  a  bit  of  roast  chicken 
or  turkey,  minced  as  fine  as  possible;  a  mashed  baked 
potato  moistened  with  dish  gravy,  a  slice  of  bread  and 
butter,  a  saucer  of  junket  or  rice  and  milk  pudding.  7  p.m., 
a  tumblerful  of  milk  and  a  slice  or  two  of  soft  milk  toast.'' 
(Thompson's  Practical  Dietetics.) 

350.  What  class  of  foods  should  predominate  for  persons 
over  sixty  years  of  age?    (May,  1893.) 

351.  Give  a  dietary  for  people  beyond  the  age  of  sixty  years, 
{January,  1898.) 

350  and  351.  The  following,  from  Yeo,  is  taken  from 
Thompson's  Practical  Dietetics:  "  Oi  animal  foods  best 
suited  for  this  time  of  life  the  following  may  be  mentioned. 


87 


PHYSIOLOGY  AND  HYGIENE. 


When  the  organs  of  mastication  are  altogether  inefficient 
these  foods  should  be  minced  or  pounded  into  a  paste  or 
otherwise  finely  divided.  Young  and  tender  chicken  and 
game  and  other  tender  meats.  .  .  .  White  fish,  best 
when  boiled.  Bacon,  grilled;  eggs  lightly  cooked  or  beaten 
up  with  milk.  Nutritious  soups,  such  as  chicken  or  fish, 
beef-tea,  mutton  and  chicken  broths.  Milk  in  all  forms 
when  easily  digested.  .  .  .  Bread  and  milk  made  with 
the  crumb  of  stale  bread.  Porridge  and  oatmeal  gruel. 
Puddings  of  ground  rice,  tapioca,  arrowroot,  sago,  macaroni 
with  milk  or  eggs.  .  .  .  Artificial  foods,  consisting  of 
predigested  starches.  Vegetable  purees  of  all  kinds  in 
moderation,  stewed  celery.  Stewed  or  baked  fruits  and 
fruit  jellies.'' 

352,  What  is  the  daily  quantity  of  food  required  to  nourish 
the  human  system?     (January,  1895.) 

352.  Egbert's  Hygiene  and  Sanitation,  page  228;  and 
Collins  and  Rockwell's  Physiology,  page  137. 

853.  Mention  a  daily  ration  containing  the  proper  relative 
proportion  of  proteids,  fats,  and  carbohydrates.    (May,  1902.) 

353.  The  following  is  quoted  as  an  '4deal  ration"  in 
Thompson's  Practical  Dietetics: 


Material. 

Amount. 

Proteid 

Fats 

Carbohydrates 

(ounces) . 

(ounces) . 

(ounces). 

(ounces). 

Bread      .     . 

16 

1.12 

0.08 

9.04 

Meat 

8 

1.20 

0.40 

■ 

Oysters 

8 

0.44 

0.07 

•   •   •   • 

Breakfast  cocoa 

1 

0.23 

0.26 

0.34 

MHk       .      .     . 

4 

0.13 

0.16 

0.17 

Broth     .      .      . 

16 

0.64 

0.64 

3.20 

Sugar 

1 

•    .    .    > 

.... 

0.96 

Butter    . 

h 

. .  , . 

.... 

.... 

354'  Describe  the  effects  of  a  cereal  diet.     [September, 
1897.) 


88  PHYSIOLOGY  AND  HYGIENE, 

354.  From  a  cereal  diet  alone,  the  maximum  of  work 
and  energy,  either  mental  or  physical,  cannot  be  obtained. 
*'It  is  claimed  that  a  vegetable  diet  favors  the  deposition 
of  mineral  salts  in  different  parts  of  the  body,  as  phosphatic 
stone,  gravel,  the  tartar  on  the  teeth,  and  that  living  upon 
coarse  cereals  alone  makes  the  skin  rough  and  the  indi- 
vidual dull,  heavy,  and  ill-tempered."  (Thompson's  Prac- 
tical Dietetics);  and  see  Egbert's  Hygiene  and  Sanitation, 
page  252. 

355.  What  is  the  effect  of  an  excessive  meat  diet?  {Septem- 
ber, 1896.) 

355.  See  Q.  357  (b). 

356.  What  effect  does  an  excessive  starchy  diet  produce? 
{September,  1892.) 

356.  It  may  produce  dyspepsia,  flatulence,  diarrhoea, 
glycosuria,  or  obesity. 

357.  (a)  Give  a  fattening  diet,  (b)  What  are  the  effects 
of  too  much  food  on  the  human  system?    {June,  1897.) 

357.  (a)  ''When  the  digestive  organs  admit,  the  follow- 
ing articles  may  be  prescribed  in  the  diet:  Abimdant  fat 
meats,  butter,  cream,  milk,  cocoa,  and  chocolate.  Bread, 
potatoes,  legumes,  well-cooked  cereals,  especially  oatmeal 
and  cornmeal,  farinaceous  puddings  with  sugar  and  cream 
cake,  sweets,  syrup,  honey,  sweet  wines,  port,  porter,  stout, 
ales,  and  beer.  Malt  preparations  of  all  sorts  are  also 
useful.  Sweet  fruits  may  be  eaten.  To  be  avoided  are: 
pickles,  acids,  condiments,  much  bulk  of  green  vegetables, 
and  strong  liquors."  (Thompson's  Practical  Dietetics.)  (b) 
''  Overeating  not  only  taxes  the  digestive  system,  but,  what 
is  often  more  serious,  it  throws  too  great  a  strain  upon  the 
glandular  and  excretory  organs,  especially  the  liver  and 
kidneys,  and  if  the  habit  is  long  continued  disease  inevi- 
tably results Chronic  overeating  may  cause 

such   diseases   or   diatheses   as   obesity,   gout,   lithsemia, 
oxaluria,  and  the  formation  of  renal,  vesical,  and  hepatic 


89  PHYSIOLOGY  AND  HYGIENE. 

calculi.  It  is  certain  to  cause  congestion  of  the  liver  and 
the  condition  known  as  'biliousness/  in  which  the  stomach 
and  intestines  are  engorged,  constipation  results,  the  tongue 
is  heavily  coated,  the  bodily  secretions  are  altered  in  com- 
position, the  urine  especially  becoming  overloaded  with 
salts,  the  liver  becomes  congested,  and  finally  the  nervous 
and  muscular  systems  are  affected,  with  the  results  of  the 
production  of  headache  and  feelings  of  fatigue,  lassitude, 
drowsiness,  and  mental  stupor/'  (Thompson's  Practical 
Dietetics.) 

358.  (a)  Describe  the  'physiological  causes  of  obesity. 
{May,  1894.) 

359.  (a)  What  physiological  causes  tend  to  produce  obesity? 
{September,  1896.) 

360.  (b)  What  kinds  of  food  would  you  recommend  in 
cases  of  obesity f    {January,  1893.) 

361.  (b)  What  diet  should  be  advised  to  reduce  obesity? 
{September,  1895.) 

362.  (b)  Indicate  hygienic  treatment  to  reduce  excess  of 
fat  in  an  unmarried  woman  whose  organs  are  normal. 
{January,  1902.) 

358  to  362.  (a)  Heredity,  age,  overeating,  ingestion  of 
too  much  carbohydrate  food,  idiosyncrasy,  lack  of  exercise, 
(b)    Diminish   the   carbohydrates,   give   saline   laxatives, , 
massage,  gradual  exercise;  and  see  A.  to  365  (b). 

363.  How  should  diet  in  Cuba  differ  from  diet  in  Gree7i- 
landf     {January,  1901.) 

363.  Diet  in  Cuba  should  consist  of  more  fruit  and 
vegetables,  less  meat  and  fat,  and  the  total  quantity  should 
be  diminished  somewhat.  In  Greenland  a  larger  quantity 
would  be  required,  and  a  considerable  amount  of  fatty 
food  would  be  consumed;  this  latter  would,  on  being 
oxidized  in  the  body,  furnish  a  large  supply  of  heat. 

364-  What  precautions  as  to  food  and  drink  should  be 
observed  by  those  forced  to  work  under  the  direct  rays  of  the 
sun  in  summer  weather?    {May,  1896.) 


90  PHYSIOLOGY  AND  HYGIENE. 

364.  ^'Moderation  of  diet  is  especially  to  be  enjoined. 
Very  little  animal  food  should  be  taken;  the  food,  while 
sufficiently  nutritious,  should  be  light  and  unstimulating. 
Iced  water  should  be  drunk  freely  and  frequently,  and  the 
greatest  moderation  in  the  use  of  stimulants  should  be 
observed.  Excesses  in  eating  and  drinking  are  to  be 
deprecated.'^     (AUbutt's  System  of  Medicine.) 

365.  Indicate  a  proper  diet  in  a  case  of  (a)  diabetes 
'  mellitus,  (b)  obesity,  and  (c)  early  convalescence  from  typhoid 
fever.     {January,  1899.) 

365.  (a)  " During' s  diet  for  Diabetes  is  as  follows:  Early 
Breakfast. — Milk,  with  a  little  coffee  but  no  sugar  (lime- 
water,  to  prevent  milk  from  souring  in  the  stomach) ;  stale 
white  bread  ad  libitum,  or,  if  it  is  not  well  borne,  oatmeal, 
barley,  or  rice  gruel  made  with  water,  a  little  salt,  but  no 
butter.  Second  Breakfast. — White  bread,  stale  and  well 
baked;  an  egg,  lightly  boiled;  rice  or  oatmeal  gruel,  with 
or  without  milk,  a  breakf astcupf ul ;  or  half  a  glass  of  good 
red  wine  (with  water  in  certain  cases).  Dinner  (taken 
between  two  and  three  o'clock). — Soup,  with  rice,  barley, 
or  oatmeal;  meat,  roasted,  two  hundred  and  fifty  grammes 
(game,  ham,  and  smoked  meats,  as  free  from  fat  as  possible, 
are  permissible);  no  condiments,  no  fatty  sauces;  compote 
of  dried  apples,  plums,  cherries;  dried  peas  or  white  beans 
in  some  cases;  green  vegetables,  asparagus,  French  beans, 
carrots,  cauliflower,  cabbage  (boiled  in  water  with  salt, 
not  with  fat  or  stock) ;  dessert  of  a  little  raw  fruit,  apples, 
cherries,  and  one  small  glass  of  red  wine  diluted  with  water. 
Supper  (about  7  p.m.). — Gruel  of  barley,  oatmeal,  or  rice, 
with  salt  (but  no  butter),  and  strained,  which  in  some 
cases  may  be  made  with  milk.  Ice  or  iced  water,  to  relieve 
thirst  between  meals."  (Thompson's  Practical  Dietetics.) 
(b)  "Ebstein's  diet  for  Obesity  is  as  follows:  Breakfast  con- 
sists of  a  cup  of  black  tea  without  sugar  or  milk  and  two 
o\mces  of  buttered  toast.  Dinner,  which  is  given  at  noon, 
comprises  a  meat  soup  or  broth;  four  to  six  ounces  of 


91  PHYSIOLOGY  AND  HYGIENE. 

boiled  or  roasted  fat  beef  with  meat  gravy,  not  thickened; 
one  or  two  fresh  vegetables,  in  moderation;  and  for  dessert 
salads  and  fresh  or  dried  fruits.  He  allows  a  little  light 
wine  and  black  tea  without  milk  or  sugar.  Supper  includes 
tea  as  before,  a  soft-cooked  egg,  and  a  moderate  allowance 
of  fish,  ham,  or  cold  fat  meat,  an  ounce  of  thin  buttered 
bread  or  toast,  and  fresh  fruit."  (Thompson's  Practical 
Dietetics.)  (c)  ^'The  following  is  a  list  of  foods  suitable 
for  the  different  days  of  convalescence  (from  typhoid  fever)  ^ 
commencing  a  day  or  two  after  disappearance  of  all  fever. 
Milk  should  still  be  given  until  gradually  wholly  replaced 
by  solid  food.  First  Day. — Chicken  broth  thickened  with 
thoroughly  boiled  rice.  Milk  toast  or  cream| toast  once 
only  during  the  day.  Beef-juice.  Second  Day. — Junket, 
mutton  broth,  and  bread  crimibs.  Cocoa;  milk  toast.  A 
piece  of  tender  steak  may  be  chewed,  but  not  swallowed. 
One  of  the  prepared  farinaceous  foods,  such  as  Mellin's 
or  Horlick's,  may  be  given  with  a  cup  of  hot  milk.  Third 
Day. — A  small  scraped-beef  sandwich  at  noon.  A  soft- 
cooked  egg  or  baked  custard  for  supper.  Boiled  rice  or 
potato  puree  strained.  Arrowroot  gruel.''  (Thompson's 
Practical  Dietetics.) 

VII.  EXCRETION. 

1.  The  Kidneys  and  the  Urine. 

366.  What  changes  take  place  in  the  composition  of  blood 
as  it  passes  through  the  kidneys?    {January,  1895.) 

366.  See  A.  154  (5). 

367.  Describe  the  function   of  the  kidneys.     {September^ 
1901.) 

368.  Describe    the    physiological   action   of   the   kidneys. 
{November,  1894.) 

367  and  368.  The  function  of  the  kidneys  is  to  secrete 
urine.     (See  Collins  and  Rockwell's  Physiology,  page  131.) 


92  PHYSIOLOGY  AND  HYGIENE. 

369.  Give  the  ^physiology  of  urine  excretion.    {June,  1897.) 

370.  Describe  the  excretion  of  urine  hy  the  kidneys.  (Sep- 
tember, 1898.) 

371.  Describe  the  excretion  of  urine.    {May,  1901.) 

372.  What  is  the  mechanism  of  urinary  excretion?  {March^ 
1893.) 

369  to  372.  Collins  and  RockwelFs  Physiology,  page  131. 

373.  Describe  the  mechanism  (a)  of  defecation,  (b)  of 
micturition.     {September,  1896.) 

374-  (b)  Describe  the  mechanism  of  micturition.  {JunCy 
1895.) 

375.  (c)  Give  the  nervous  mechanism  of  urination.  {May, 
1896.) 

373  to  375.  (a)  Collins  and  RockwelFs  Physiology,  page 
110;  (b)  page  133;  (c)  pages  133  and  182. 

376.  (a)  Describe  the  physical  properties  of  healthy  urine. 
{April,  1896.) 

377.  (b)  What  is  the  composition  of  urine?  (c)  Give  the 
normal  reaction  and  (d)  the  specific  gravity  of  urine.  {June, 
1899.) 

378.  (e)  Give  the  variations  within  the  limits  of  health  in 
the  specific  gravity  of  urine.    {June,  1893.) 

379.  (b)  In  one  thousand  parts  of  normal  urine  what  pro- 
portion is  water?  (b)  Mention  the  substances  that  make  up 
the  solids  in  normal  urine.    {September,  1899.) 

380.  (b)  Name  the  solids  of  the  urine  and  (f)  state  the 
approximate  amount  of  each  voided  daily  by  an  adult. 
{January,  1897.) 

381.  (g)  What  conditions  increase  the  amount  of  solids 
in  the  urine?    {July,  1893.) 

376  to  381.  (a)  Collins  and  RockwelFs  Physiology,  page 
129 ;  (b)  page  130 ;  and  see  (f ) ;  (c)  Collins  and  Rockwell's 
Physiology,  page  130;  (d)  page  129;  (e)  page  129.  (f)  "The 
following  table  shows  the  average  composition  of  urine  and 
amount  of  each  constituent  voided  daily: 


93 


PHYSIOLOGY  AND  HYGIENE. 


Voided  per  Day. 


Water      .      .      .      . 

950 

Urea  .... 

28        1 

Uric  acid 

0.60 

Hippuric  acid     . 

0.35    - 

Creatinine     . 

0.65 

Extractives  . 

8.00 

Sodium  chloride 

8.00  1 

Phosphoric  acid 

2.00 

Sulphuric  acid    . 

1.25 

Lime  (CaO)  .      . 

0.25   I 

Magnesia  (MgO) 

0.30   1 

Potash  (KjO)  and^sc 

)da 

(N( 

ifi)  0.60  J 

Grains. 
Organic  520.80 


matter, 
37.60 


11.16 
6.51 

12.09 

148.80 

148.80 

T  .    37.20 

Inorganic  go  45 

matter,      ^^g 

5.58 
11.16 


12.40 


Total    . 

Water 

Organic  matter . 
Inorganic  matter 


1000.00 

950.00 
37.60 
12.40 


930.20 

699.36 
230.64 


Grams. 

35.00 

0.75 

0.44 

0.81 

10.00 

10.00 

2.50 

1.56 

0.31 

0.37 

0.75 

62.49 

47.00 
15.49 


The  average  quantity  of  urine  voided  in  twenty-four  hours 
is  from  forty  to  sixty  fiuidounces.''  (DungUson's  Medical 
Dictionary.)  (g)  Meat  diet,  muscular  exertion,  mental 
effort,  worry,  hysteria,  fevers,  diabetes,  nephritis,  dyspepsia, 
and  many  other  diseases. 

S82.  Describe  urea,  (a)  its  occurrence,  (b)  variations  in 
the  quantity  excreted,  and  (c)  recognition  in  the  voided  urine. 
{September,  1894.) 

383.  (b)  What  conditions  within  normal  limits  will  modify 
the  quantity  of  urea  in  the  urine?    {November,  1891.) 

384.  State  what  you  know  about  urea.    {April,  1893.) 
382  to  384.  Collins  and  Rockwell's  Physiology,  page  134. 

(a)  Urea  is  the  chief  solid  constituent  of  the  urine;  it  is 
also  found  in  blood,  lymph,  chyle,  muscle  tissue,  bile, 
perspiration,  saliva,  milk,  liver,  lungs,  spleen,  and  brain. 

(b)  The  amount  of  urea  eliminated  varies  with  age,  sex, 
and  diet.  In  infancy  there  is  little  or  no  urea  eliminated; 
growing  children  void  relatively  more  urea  than  adults; 
in  old  age  the  quantity  is  diminished.  Males  excrete  more 
urea  than  females ;  during  pregnancy  females  excrete  more 


11 


94  PHYSIOLOGY  AND  HYGIENE. 

urea  than  males.  A  heavy  meat  diet  and  large  quantities 
of  water  increase  the  output  of  urea.  It  is  also  believed 
that  exercise  increases  the  amount  of  urea  excreted,  (c) 
''There  are  no  very  characteristic  reactions  by  which  urea 
can  be  well  recognized.  From  organic  mixtures  it  is  sepa- 
rated by  digesting  them  with  from  3  to  4  volimies  of  alcohol 
in  the  cold ;  the  filtered  liquid  is  evaporated  to  dryness  and 
extracted  with  alcohol,  which  again  is  evaporated.  The 
dry  residue  may  be  tested  for  urea  as  follows :  (1)  Dissolved 
in  a  few  drops  of  water,  the  addition  of  an  equal  quantity 
of  colorless  nitric  acid  causes  the  formation  of  white, 
shining,  crystalline  plates  or  prisms  of  urea  nitrate.  (2)  If 
a  strong  solution  of  oxalic  acid  is  added  instead  of  nitric 
acid,  rhombic  plates  of  urea  oxalate  form.  (3)  The  residue 
(or  urea)  heated  in  a  test-tube  to  about  160°  C.  (320°  F.), 
until  no  more  vapors  of  ammonia  are  evolved,  leaves  a 
substance  termed  biuret,  Cfl^fi^,  which  upon  the  addition 
of  a  few  drops  of  potassium  hydroxide  solution  and  a  drop 
of  cupric  sulphate  solution  causes  the  solution  of  the  cupric 
hydroxide  with  a  reddish-violet  color."  (Dunglison's  Med- 
ical Dictionary.) 

2.  The  Skin. 

885.  What  are  the  functions  of  the  skin?    {January,  1892.) 

386.  What  are  the  functions  of  the  skin?    {June,  1893.) 

387.  What  are  the  functions  of  the  skin  and  its  appendages? 
{May,  1899.) 

385  to  387.  The  functions  of  the  skin  and  its  appendages 
are:  protection,  excretion,  heat  regulation,  absorption, 
sensation,  respiration. 

388.  (a)  What  matters  are  excreted  by  the  skin?  (b)  How 
may  the  function  of  the  skin  be  affected  as  to  amount  of 
excretion?     {January,  1900.) 

388.  (a)  Sebum  and  sweat,  (b)  Collins  and  Rockwell's 
Physiology,  page  125. 

389.  What  is  the  function  of  (a)  the  sudoriferous  glands; 
(b)  the  sebaceous  glands?    {April,  1894-) 


95  PHYSIOLOGY  AND  HYGIENE. 

390.  (a),  (b)  Mention  the  glands  of  the  skin  and  give  their 
function.     (May,  1897.) 

389  and  390.  (a)  Collins  and  Rockwell's  Physiology, 
pages  122  and  124;  (b)  pages  122  and  125. 

391.  What  is  the  composition  of  the  sweat?  {January, 
1894,) 

391. 

Water 98.88 

SoUds 1.12 

( Fats  and  fatty  acids    .      .      .      .      .      .     0.41 

0  6^    ]  Epithelium 0.17 

^  Urea  and  other  nitrogenous  compounds     0.08 

Inorganic  J  Sodium  chloride 0.28 

0.46        I  Other  salts 0.18 

(From  Hall's  Physiology.) 

392.  What  are  the  uses  of  the  perspiration?  {July,  1893.) 

392.  Collins  and  Rockwell's  Physiology,  page  125. 

393,  What  relation  does  the  nervous  system  hear  to  the 
excretion  of  perspiration?    {January,  1896.) 

393.  Collins  and  Rockwell's  Physiology,  page  125. 

VIII.  METABOLISM  OF  TISSUES. 

1.  Muscular  Metabolism. 

394-  (a)  What  stimuli  produce  muscular  contraction?  (b) 
What  is  the  nervous  mechanism  of  muscular  contraction? 
Illustrate.    {June,  1899.) 

395.  (b)  Describe  the  mechanism  of  muscular  contraction. 
{January,  1893.) 

396.  (c)  Differentiate  tonic  muscular  contraction  and  clonic 
muscular  contraction.    {May,  1902.) 

397.  (c)  Define  tonic  muscular  contraction,  clonic  muscu- 
lar contraction.    Give  an  example  of  each.    {April,  1899.) 

394  to  397.  (a)  Collins  and  Rockwell's  Physiology,  page 
150;  (b)  pages  148  and  149.     (c)  In  tonic  muscular  con- 


96  PHYSIOLOGY  AND  HYGIENE. 

traction  the  muscle  remains  for  some  time  in  a  state  of 
rigid  contraction;  in  clonic  contraction,  the  muscle  alter- 
nately contracts  and  relaxes.  Tonic  muscular  contraction 
occurs  in  tetanus;  clonic  in  an  ordinary  convulsion. 

398.  What  changes  take  place  in  a  muscle  during  con- 
traction?    (June,   1893.) 

399.  Describe  the  changes  in  form  and  volume,  and  in 
physical  and  chemical  properties,  occurring  in  the  contraction 
of  a  muscle.     (April,  1896.) 

398  and  399.  During  contraction  the  following  changes 
take  place  in  a  muscle: 

1.  It  becomes  shorter  and  thicker,  but 

2.  There  is  no  change  in  volume  or  bulk. 

3.  There  is  an  increased  consumption  of  oxygen. 

4.  More  carbon  dioxide  is  set  free. 

5.  The  muscle  becomes  acid  in  reaction,  due  to 

6.  Formation  of  sarcolactic  acid. 

7.  Its  extensibility  is  increased. 

8.  Its  elasticity  is  diminished. 

9.  There  is  an  increase  in  heat  production,  and  conse- 
quently a  rise  of  temperature. 

10.  The  electric  reaction  becomes  relatively  negative. 

11.  A  sound  is  produced. 

JflO.  What  is  meant  hy  the  condition  of  tetanus  in  a  muscle  f 
(March,  1893.) 

400.  Collins  and  Rockwell's  Physiology,  page  153. 

401.  How  do  the  striped  and  the  unstriped  muscular  fibres 
differ  in  response  to  stimuli?    (January,  1896.) 

401.  Collins  and  Rockwell's  Physiology,  page  151. 

If.02.  Give  the  causes  of  muscular  fatigue.    (May,  1896.) 

402.  Collins  and  Rockwell's  Physiology,  page  147. 

Jf.03.  Describe  the  metabolism  of  muscle  during  activity. 
{January,  1902.) 

JfiJ^.  What  is  the  effect  of  suspended  functional  activity  on 
muscles?     (November,  1893.) 


97  PHYSIOLOGY  AND  HYGIENE. 

403  and  404.  Collins  and  Rockwell's  Physiology,  page 
145;  and  see  Q.  398  and  399. 

406.  (a)  What  is  rigor  mortis f  (b)  What  is  tetanus? 
(March,  1893.) 

406.  (a)  Describe  the  rigor  mortis.     (March,  1893.) 

407.  (c)  What  is  the  order  of  occurrence  of  rigor  mortis 
in  the  different  parts  of  the  body?    (January,  1893.) 

408.  (a)  Define  rigor  mortis,  (d)  What  regulates  its  onset 
and  duration?     (March,  1892.) 

409.  Give  (e)  the  cause  and  (c)  the  order  of  occurrence  of 
rigor  mortis.     (May,  1893.) 

405  to  409.  (a)  Collins  and  Rockwell's  Physiology,  page 
158;  (b)  see  Q.  400;  (c)  Collins  and  Rockwell's  Physiology, 
page  159;  (d)  page  158;  (e)  page  159. 

2.  Glandular  Metabolism. 

410.  Describe  an  epithelial  secreting  surface.  (January, 
1892.) 

410.  Collins  and  Rockwell's  Physiology,  page  116. 

411.  Explain  the  anatomical  and  physiological  differences 
between  mucous,  serous,  and  synovial  membranes.  (Novem- 
ber, 1892.) 

412.  What  is  the  function  of  the  serous  and  of  the  synovial 
membranes?     (November,  1892.) 

411  and  412.  ^^  Mucous  membrane,  so  called  on  account 
of  the  mucous  fluid  by  which  it  is  constantly  lubricated. 
Mucous  membranes  line  the  canals,  cavities,  and  hollow 
organs  which  communicate  externally  by  different  aper- 
tures on  the  skin.  Bichat  refers  them  to  two  great  divisions 
— the  gastropidmonary  and  the  genito-urinary .  Mucous 
membranes  have  a  striking  analogy  with  the  cutaneous 
tissue  in  organization,  functions,  and  diseases.  They  are 
composed  of  corium,  papillae,  and  epidermis,  and  are 
furnished  with  a  multitude  of  follicles  which  secrete  a 
viscid  humor — mucus.    They  receive  a  number  of  arterial 


98  PHYSIOLOGY  AND  HYGIENE. 

vessels,  veins,  lymphatics,  and  nerves.  The  serous  mem- 
branes are  transparent  and  thin.  One  surface  adheres  to 
other  textures ;  the  other  is  smooth,  polished,  and  moistened 
by  a  serous  fluid.  Serous  membranes  resemble  the  areolar 
membrane  in  structure  and  diseases.  They  facilitate  the 
motion  on  each  other  of  the  organs  which  they  envelop. 
They  may  be  divided  into  (a)  Serous  membranes,  properly 
so  called,  as  the  arachnoid,  pleura,  peritoneum,  and  tunica 
vaginalis;  (b)  Synovial  membranes  or  capsules,  which 
belong  to  joints,  tendons  aponeuroses,  etc.  These  mem- 
branes— mucous  and  serous — are  constituted  of  similar 
layers — epithelial,  basement  membrane,  condensed  areolar 
tissue — and  a  looser  form  of  areolar  tissue,  termed  sub- 
mucous in  one  case,  subserous  in  the  other.''  (Dunglison's 
Medical  Dictionary.)  And  see  Collins  and  Rockwell's 
Physiology,  page  118. 

4-13.  What  office  is  performed  by  (a)  synovial  membrane; 
(b)  joint  ligaments?     (November,  1892.) 

413.  (a)  ^'To  diminish  friction  between  the  articular 
ends  of  the  bones  forming  a  movable  joint;  between  a 
tendon  and  a  bone,  where  the  former  glides  over  the  latter; 
and  between  the  skin  and  various  subcutaneous  bony 
prominences."  (Gray's  Anatomy.)  (b)  Ligaments  connect 
bones  in  the  formation  of  a  joint,  bones  with  soft  parts, 
cartilages,  soft  parts  with  soft  parts. 

41Ji..  Define  and  illustrate  simple  tubular  glands,  compound 
tubular  glands,  racemose  glands.    {April,  1893.) 

4-15.  Give  a  general  description  of  secreting  glands.  {Sep- 
tember, 1892.) 

414  and  415.  Collins  and  Rockwell's  Physiology,  page 
116. 

416.  Define  (a)  metabolism,  (b)  assimilation,  (c)  secretion, 
and  (d)  excretion.     {November,  1891.) 

417.  Define  (c)  secretion,  (d)  excretion,  (e)  protoplasm j 
(b)  assimilation.    Give  an  example  of  each.    {March,  1892.) 


99  PHYSIOLOGY  AND  HYGIENE. 

Jf.18.  Define  (c)  secretion  and  (d)  excretion,  and  give  an 
example  of  each.     (September,  1892.) 

419.  What  is  the  difference  between  (c)  secretion  and  (d) 
excretion  in  glandular  function?  Give  an  illustration  of  each. 
(March,  1892.) 

420.  Define  (c)  secretion;  (d)  excretion.  Give  two  examples 
of  each.     (November,  1891.) 

421.  Define  (c)  secretion;  (d)  excretion,  (f)  Give  the 
function  of  three  secretions  in  the  human  economy.  (January, 
1893.) 

422.  (c)  What  do  you  understand  by  secretion?  (No- 
vember, 1891.) 

423.  (g)  Name  seven  secretions  and  give  the  functions  of 
each.     (June,  1892.) 

4^4'  (g)  Name  the  secretions  of  the  body.    (June,  1892.) 
4^5.  (g)  Name  the  secretions  and  give  the  functions  of 
each.     (November,  1892.) 

426.  (h)  Name  the  excretory  glands  of  the  body  and  the 
function  of  each.     (March,  1892.) 

427.  (h)  Name  the  excretions  of  the  body.    (April,  1893.) 
416  to  427.  (a)  Collins  and  Rockwell's  Physiology,  page 

18;  (b)  page  140;  (c)  page  115;  (d)  page  115;  (e)  pages  19 
and  22;  (f)  page  136;  (g)  pages  136  and  115;  (h)  pages 
136  and  115;  the  excretions  proper  are  sweat,  urine,  and 
bile. 

4^8.  (a)  Name  two  circumstances  influencing  secretion. 
(November,  1892.) 

429.  (b)  What  is  the  influence  of  the  nervous  system  on 
glandular  secretion?     (November,  1892.) 

430.  (b)  What  influence  has  the  nervous  system  on  the 
process  of  secretion?     (November,  1891.) 

428  to  430.  (a)  Colhns  and  Rockwell's  Physiology,  page 
117;  (b)  page  117. 

431.  Describe  the  process  of  secretion  from  a  typical  gland 

such  as  the  submaxillary.     (June,  1892.) 


100  PHYSIOLOGY  AND  HYGIENE. 

431.  ''In  the  submaxillary  gland,  a  portion  of  which 
may  be  taken  as  a  type  of  a  mucous  gland,  changes  have 
been  observed  similar  to  those  described  in  the  case  of  the 
parotid  gland.  (See  answer  to  Q.  212.)  During  rest  the 
epithelial  cells  are  large,  clear  in  appearance,  highly  re- 
fractive, and  loaded  with  small  globules  resembling  mucin. 
The  nucleus,  surrounded  by  a  small  quantity  of  proto- 
plasm, lies  near  the  margin  of  the  cell.  That  the  granules 
are  not  protoplasmic  in  character  is  shown  by  the  fact 
that  they  do  not  stain  on  the  addition  of  carmine.  When 
treated  with  water  or  .dilute  acids  the  globules  swell  up, 
coalesce,  and  form  a  uniform  mass.  The  chemical  relations 
of  this  substance  indicate  that  it  is  the  precursor  of  mucin, 
namely,  mucigen.  During  secretory  activity  the  cells  dis- 
charge these  mucigen  granules  into  the  lumen  of  the  acinus, 
where  they  are  transformed  into  mucin.  Though  the 
appearance  of  the  gland  cell  appears  to  indicate  it,  there 
is  no  evidence  for  the  view  that  the  cell  itself  undergoes 
disintegration  in  the  process."  (Brubaker's  Text-hook  of 
Physiology.) 

482.  Mention  the  secreting  membranes  of  the  body  and 
state  the  function  or  functions  of  each.    (June,  1892.) 

432.  ColUns  and  Rockwell's  Physiology,  pages  118,  115, 
and  136. 

3.  The  Ductless  Glands. 

J^33.  (a)  Mention  the  ductless  glands  and  (b)  give  the 
theory  as  to  the  functions  of  any  one  of  them.  (September, 
1892.) 

434.  (b)  State  the  theories  held  regarding  the  function  of 
the  spleen.     (November,  1892.) 

435.  (c)  What  explanation  may  be  given  for  enlargement 
of  the  spleen  in  leukocythcemiaf     (November,  1892.) 

433  to  435.  (a)  The  ductless  glands  are:  the  spleen, 
thyroid,  thymus,  suprarenal  capsules,  parathyroids,  carotid 
and  coccygeal  glands,  and  the  pituitary  body,     (b)  The 


101  PHYSIOLOGY  AND  HYGIENE. 

following  theories  have  been  held  regarding  the  functions 
of  the  spleen:  (1)  it  is  a  source  of  production  of  white 
blood  corpuscles;  (2)  it  is  a  source  of  production  of  red 
blood  corpuscles  during  foetal  life;  (3)  it  is  a  place  where 
the  red  blood  corpuscles  are  destroyed;  (4)  uric  acid  is 
produced  in  the  spleen;  (5)  an  enzyme  is  produced  in  the 
spleen,  this  enzyme  is  carried  by  the  blood  to  the  pancreas, 
and  there  converts  the  trypsinogen  found  in  that  gland  into 
trypsin,  (c)  In  leukocythsemia  the  spleen  is  enlarged  owing 
to  the  great  increase  in  the  number  of  white  blood  cor- 
puscles found  in  this  condition ;  these  white  blood  corpuscles 
are  supposed  to  be  manufactured  in  the  spleen.    See  (b). 

436.  What  effects  are  produced  in  the  system  by  the  removal 
of  the  thyroid  gland f    (March,  1892.) 

436.  The  face  becomes  white,  puffy,  and  loses  all  expres- 
sion; the  mental  and  intellectual  faculties  become  dulled, 
and  may  terminate  in  idiocy;  the  heart  becomes  slowed, 
blood  pressure  lowered;  temperature  may  be  subnormal; 
albuminuria  and  dyspnoea  may  be  present;  the  pufhness 
of  the  face  extends  to  the  neck  and  supraclavicular  fossse; 
the  tongue  is  enlarged  and  speech  is  slow  and  measured; 
the  extremities  become  enlarged  and  movements  are  slow, 
labored,  and  clumsy. 

4S7.  In  what  glands  of  the  body  is  function  undetermined? 
{September,  1892.) 

438.  Name  structures  in  the  body  whose  functions  are 
doubtful  or  unknown.     (March,  1893.) 

437  and  438.  See  A.  433  (a),  omitting  suprarenal  cap- 
sules. 

IX.  ANIMAL  HEAT. 

439.  (a)  What  is  animal  heat,  and  (b)  how  is  it  produced? 
(November,  1892.) 

440.  (b)  What  is  the  mode  of  production  of  heat  in  the 
body?     (June,  1892.) 

441 '  (c)  How  is  the  heat  of  the  body  maintained?  (Sep- 
tember, 1892.) 


12 


102  PHYSIOLOGY  AND  HYGIENE. 

442.  (d)  What  is  the  normal  body  temperature?  (c)  How 
is  it  regulated  and  sustained?     (November,  1892.) 

44$.  (c)  How  is  the  temperature  of  the  body  regulated? 
{January,  1893.) 

444.  (c)  By  what  means  is  the  body  temperature  regulated 
and  kept  uniform?     {March,  1892.) 

445.  (c)  What  conditions  tend  to  keep  the  body  temperature 
uniform?     {May,  1893.) 

439  to  445.  (a)  ''By  animal  heat  is  understood  the  heat 
that  is  constantly  being  formed  by  the  body  of  a  living 
animal,  by  which  it  preserves  nearly  same  temperature 
whatever  may  be  that  of  the  medium  in  which  it  is  placed. 
It  takes  place  over  the  whole  body,  in  production  of 
carbonic  acid,  and  in  other  oxidizing  processes,  and  in 
changes  in  nutrition/'  (From  Dunglison's  Medical  Dic- 
tionary.) (b)  ColUns  and  Rockwell's  Physiology,  page  14.0; 
(c)  page  141;  (d)  page  140. 

44^'  {^)  What  variations  of  temperature  are  found  in 
different  parts  of  the  body?  (b)  Mention  the  reasons  for  such 
variations.     {July,  1893.) 

44"^'  (b)  What  conditions  produce  variations  in  the  normal 
temperature  of  the  body?    {April,  1893.) 

448.  (b)  What  conditions  influence  the  temperature  of  the 
body?    {March,  1893.) 

44^'  (b)  Mention  the  conditions  that  cause  variation  in 
the  amount  of  animal  heat  produced  in  the  body.  {January, 
1892.) 

450.  (b)  Give  the  causes  of  variation  in  the  heat  of  the 
body.     (March,  1892.) 

446  to  450.  (a)  Collins  and  Rockwell's  Physiology,  page 
140.  Hall,  in  his  Text-book  of  Physiology,  gives  the  follow- 
ing temperatures:  Bend  of  knee,  35°  C.;  inguinal  fold, 
35.8°  C;  closed  axilla,  36.5°  C;  mouth  (under  tongue), 
37.2°  C;  rectum,  38°  C;  vagina,  38.3°  C.  (b)  Age,  sex, 
climate  and  season,  bodily  and  mental  activity,  bathing, 
food,  sleep,  drugs,  and  diseases. 


1Q3  PHYSIOLOGY  AND  HYGIENE. 

451.  (a)  How  is  the  average  temperature  of  the  body  main- 
tained? (b)  Give  the  normal  temperature  of  the  body  as 
shown  by  (1)  the  mouth,  (2)  the  rectum.    {June,  1892.) 

451.  (a)  See  Q.  439  to  445  (c);  (b)  see  Q.  446  (a). 

Jj.52.  Wherein  does  the  temperature  of  the  body  in  advanced 
age  differ  from  its  temperature  in  middle  life?  What  is  the 
temperature  of  the  newborn  child?    {April,  18 98.) 

452.  "The  average  temperature  of  the  newborn  child 
is  only  about  half  a  degree  C.  (1°  F.)  above  that  of  the 
adult ;  and  the  difference  becomes  still  more  trifling  during 
infancy  and  early  childhood.  The  temperature  falls  to  the 
extent  of  about  0.2°  C.  (0.5°  F.)  from  early  infancy  to 
puberty,  and  by  about  the  same  amoimt  from  puberty  to 
fifty  or  sixty  years  of  age.  In  old  age  the  temperature 
again  rises,  and  approaches  that  of  infancy.''  (Kirkes' 
Fhysiology.) 

4.53.  Give  the  difference  (a)  between  the  temperature  of  a 
newborn  child  and  that  of  an  adult;  (b)  between  the  temper- 
ature of  a  person  intoxicated  by  alcoholic  drink  and  his 
temperature  after  the  first  stimulating  drink  of  liquor.  {Janu- 
ary, 1893.) 

453.  (a)  See  Q.  452.  (b)  In  a  person  intoxicated  by 
alcoholic  drink,  the  body  temperature  will  be  lowered; 
whereas,  after  the  first  stimulating  drink  it  may  be  tempo- 
rarily raised  a  little. 

454.  (a)  State  the  conditions  that  affect  bodily  temperature. 
(b)  What  mechanism  is  concerned  in  therinogenesis?  (c) 
Explain  occasional  post-mortem  rise  of  temperature.  {Janu- 
ary, 1893.) 

454.  (a)  See  Q.  446  to  450  (b).  (b)  The  mechanism  con- 
cerned in  thermogenesis  consists  of:  (1)  thermogenetic 
tissues,  such  as  voluntary  muscles,  glands,  the  heart;  (2) 
thermogenetic  nerves;  and  (3)  thermogenetic  centres  in  the 
cortex  and  base  of  the  brain,  pons,  medulla,  and  spinal 
cord;  these  centres  are  of  two  kinds,  thermo-accelerator  and 


104  PHYSIOLOGY  AND  HYGIENE. 

thermo-inhihitory .  (c)  '^The  most  important  factors  are 
these :  When  the  circulation  and  respiration  cease  at  death, 
the  normal  loss  of  heat  from  these  causes  and  from  sweating 
also  comes  to  an  end,  but  the  tissues  live  for  a  short  time 
and  produce  heat  even  after  the  death  of  the  organism  as 
a,  whole.  If  this  production  of  heat  is  greater  than  the  loss 
of  heat  from  the  corpse,  the  temperature  rises;  if,  on  the 
other  hand,  it  is  less,  then  the  effect  is  only  to  delay  the 
fall  of  temperature.  The  next  source  of  heat  is  in  the 
muscles  on  the  onset  of  rigidity ;  and,  finally,  when  decom- 
position sets  in,  and  this  may  after  some  diseases  occur 
exceedingly  rapidly,  there  is  a  further  production  of  heat 
due  to  putrefaction.  In  some  cases  the  temperature  of  a 
corpse  does  not  fall  to  that  of  the  atmosphere  even  in  four 
or  five  days."    (Schafer's  Text-hook  of  Physiology.) 

X.   THE  PRODUCTION  OF  THE  VOICE. 

455.  Give  the  physiology  of  the  human  voice.  (September, 
1892.) 

Jf.56.  Give  the  physiology  of  the  human  voice,  mentioning 
the  organs  and  forces  concerned  in  the  production.  (Sep- 
tember, 1892.) 

451 .  How  are  the  vocal  sounds  produced?  (January,  1895.) 

455  to  457.  Collins  and  Rockwell's  Physiology,  page  241. 

Jf.58.  Describe  the  action  of  the  vocal  cords.    (March,  1892,) 

459.  Give  the  movements  of  the  vocal  cords  in  vocalization. 
(March,  1892.) 

458  and  459.  Collins  and  Rockwell's  Physiology,  page 
241. 

460.  What  organs  constitute  the  vocal  apparatus?  Explain 
in  detail  how  they  operate  to  produce  and  modulate  the  voice. 
(May,  1893.) 

460.  See  Q.  455  to  459. 

461.  (a)  What  constitutes  the  usual  difference  between 
male  and  female  voices?    (January,  1892.) 


105  PHYSIOLOGY  AND  HYGIENE. 

4.62.  (a)  What  causes  the  difference  in  pitch  between  male 
and  female  voices?  (b)  What  causes  the  voice  of  the  youth 
at  the  period  of  puberty  to  "  crack  f    (April,  1893.) 

461  and  462.  (a)  ^'The  difference  in  the  pitch  of  the 
male  and  female  voices  depends  on  the  different  length  of 
the  vocal  cords  in  the  two  sexes;  their  relative  length  in 
men  and  women  being  as  three  to  two.  The  difference  of 
the  two  voices  in  tone  or  timbre  is  owing  to  the  different 
nature  and  form  of  the  resounding  walls,  which  in  the  male 
larynx  are  much  more  extensive,  and  form  a  more  acute 
angle  anteriorly.  The  different  qualities  of  the  tenor  and 
bass,  and  of  the  alto  and  soprano  voices,  probably  depend 
on  some  peculiarities  of  the  ligaments  and  the  membranous 
and  cartilaginous  parietes  of  the  laryngeal  cavity,  which 
are  not  at  present  understood,  but  of  which  we  may  form 
some  idea  by  recollecting  that  musical  instruments  made 
of  different  materials — e.  g.,  metallic  and  gut  strings — may 
be  tuned  to  the  same  note,  but  that  each  will  give  it  with 
a  peculiar  tone  or  timbre."  (Kirkes'  Physiology.)  (b)  ''The 
boy's  larynx  resembles  the  female  larynx;  their  vocal  cords 
before  puberty  are  not  two-thirds  the  length  of  the  adult 
cords;  and  the  angle  of  their  thyroid  cartilage  is  as  little 
prominent  as  in  the  female  larynx.  Boys'  voices  are  alto 
and  soprano,  resembling  in  pitch  those  of  women,  but 
louder,  and  differing  somewhat  from  them  in  tone.  But, 
after  the  larynx  has  undergone  the  change  produced  during 
the  period  of  development  at  puberty,  the  boy's  voice 
becomes  bass  or  tenor.  T\niile  the  change  of  form  is  taking 
place  the  voice  is  said  to  crack;  it  becomes  imperfect, 
frequently  hoarse  and  crowing,  and  is  unfitted  for  singing 
until  the  new  tones  are  brought  under  command  by 
practice."     (Kirkes'  Physiology.) 

463.  How  are  the  phenomena  of  ventriloquism  produced? 
(January,  1892.) 

463.  ''It  seems  that  the  essential  mechanical  parts  of 
the  process  of  ventriloquism  consist  in  taking  a  full  inspi- 


106  PHYSIOLOGY  AND  HYGIENE. 

ration,  then  keeping  the  muscles  of  the  chest  and  neck 
fixed,  and  speaking  with  the  mouth  almost  closed,  and 
the  lips  and  lower  jaw  as  motionless  as  possible,  while  the 
air  is  very  slowly  expired  through  a  very  narrow  glottis; 
care  being  taken  also  that  none  of  the  expired  air  passes 
through  the  nose.  But,  much  of  the  ventriloquist's  skill 
in  imitating  the  voices  coming  from  particular  directions 
consists  in  deceiving  other  senses  than  hearing.''  (Kirkes' 
Physiology.) 

464-  (a)  Define  stammering,  and  (b)  state  what  causes  it. 
(April,  1893.) 

464.  (a)  Stammering  is  defined  as  ''faltering  and  inter- 
rupted speech;  especially,  hesitancy  and  interruption  in 
speech  from  difficulty  in  enunciating  certain  letters  prop- 
erly." (Duane's  Medical  Dictionary.)  (b)  ''Stammering 
depends  on  a  want  of  harmony  between  the  action  of  the 
muscles  (chiefly  abdominal)  which  expel  air  through  the 
larynx,  and  that  of  the  muscles  which  guard  the  orifice 
(rima  glottidis)  by  which  it  escapes,  and  of  those  (of  tongue, 
palate,  etc.)  which  modulate  the  sound  to  the  form  of 
speech.  Over  either  of  these  groups  of  muscles,  by  itself, 
a  stammerer  may  have  as  much  power  as  other  people; 
but  he  cannot  harmoniously  arrange  their  conjoint 
actions."     (Kirkes'  Physiology.) 

XI.  THE  NERVOUS  SYSTEM. 
1.  The  Spinal  Cord  and  its  Nerves. 

Jf.65.  What  is  (1)  an  efferent  nerve;  (2)  an  afferent  nerve? 
Illustrate  each.     {June,  1898.) 

Jf.66.  How  are  the  motor  and  sensory  nerve  impulses  trans- 
mitted?    {June,  1892.) 

465  and  466.  Collins  and  Rockwell's  Physiology,  page 
162. 

4-67.  Give  the  mechanism  of  nerve  reflex  and  an  example 
of  its  action.     {November,  1891.) 


107  PHYSIOLOGY  AND  HYGIENE. 

J^68.  Give  two  examples  of  reflex  nerve  action.     (Aprils 
1893.) 

469.  Define  and  describe  reflex  action.    Give  four  examples 
of  reflex  action.     {January,  1902.) 

470.  Deflne  reflex  nervous  action.    Give  examples.    (Janu- 
ary, 1901.) 

467  to  470.  Collins  and  Rockwell's  Physiology,  pages 
181  to  183. 

4-71.  Give  the  physiology  of  (a)  blushing,  (b)  pallor,  (c)  tear 
shedding.     (May,  1897.) 

472.  (c)  Describe  the  origin  of  a  tear  as  the  result  of  pain. 
(May,  1894.) 

471  and  472.  (a)  and  (b)  ''Throughout  the  system  of 
bloodvessels  of  the  body  we  find  an  accompanying  intricate 
nerve  supply,  through  which  medium  the  muscular  walls 
of  the  bloodvessels  are  influenced  to  contract  or  to  relax, 
and  so  control  the  volume  of  blood  in  a  given  part.  In 
the  heart  there  are  met  everywhere  in  its  muscular  walls 
nerve  fibres  originating  in  the  cardiac  ganglia,  in  those  of 
the  sympathetic  system  elsewhere,  and  in  the  medulla 
oblongata.  None  of  these  is  subject  to  volimtary  control, 
and  stimuli  arriving  through  them  originate  by  irritation 
of  the  centres  directly  or  by  sensory  impressions  received 
by  these  centres.  In  the  latter  case  it  will  be  seen  that  a 
true  reflex  mechanism  is  called  into  play.  Dilatation  and 
contraction  of  the  smaller,  peripheral  bloodvessels,  giving 
rise  to  the  phenomena  of  blushing  and  pallor,  respectively, 
are  often  due  to  sensory  stimulation.  This  may  result  as 
a  simple  reflex  act  or  with  the  interposition  of  an  emotional 
(psychic)  state.  It  may  not  be  unjustifiable  to  consider 
the  latter  as  a  complex  reflex  action,  as  when  the  sight  of 
an  accident  happening  to  another  produces  pallor,  for 
example.''  (KsiW,  Text-book  of  Physiology.)  (c)  An  afferent 
nerve  conveys  the  sensation  of  pain,  and  an  efferent  impulse 
is  sent  reflexly  to  the  lacrymal  gland,  causing  an  increased 
secretion  of  tears. 


108  PHYSIOLOGY  AND  HYGIENE. 

Jf.73.  Explain  the  action  of  the  ano-spinal  centre  in  defeca- 
tion.    (June,  1898.) 

473.  Collins  and  RockwelFs  Physiology,  pages  183,  182 
and  110. 

474'  What  tests  should  he  applied  to  ascertain  the  integrity 
of  (a)  the  superficial  reflexes,  (b)  the  deep  reflexes?  (May, 
1901.) 

474.  (a)  *'  Superficial  Reflexes.  (1)  Plantar;  elicited  by 
stroking  or  scratching  the  sole  of  the  foot,  which  causes 
attempts  to  withdraw  the  foot  from  the  source  of  irritation. 
(2)  Gluteal;  a  contraction  of  the  gluteal  muscles  en  masse 
when  the  buttock  is  gently  pricked  or  scratched.  (3) 
Cremasteric;  when  the  thigh  is  irritated  on  its  inner  surface 
by  grasping,  stroking,  scratching,  etc.,  the  homolateral 
testicle  is  distinctly  retracted.  (4)  Erectile  reflex  of  penis; 
produced  by  gentle  friction  of  the  glans  penis,  especially 
of  the  frsenum,  resulting  in  turgidity  of  the  organ  and 
erection.  Its  analogue  in  the  female  pertains  to  the 
erection  of  the  clitoris.  (5)  Abdominal;  consists  of  a 
retraction  of  the  anterior  abdominal  walls  when  the  skin 
is  slightly  irritated.  (6)  Mammary;  in  women  a  retraction 
of  the  epigastrium  when  the  mammary  region  is  tickled.' 
(7)  Palmar;  corresponding  to  the  plantar,  usually  less 
developed  than  the  latter,  (b)  Deep  Reflexes.  (1)  Tendo 
Achillis  reflex;  when  the  extended  leg  is  supported  at  the 
knee,  the  hand  pressing  firmly  against  the  ball  of  the  foot, 
a  tap  on  the  tendo  Achillis  causes  contraction  of  the 
gastrocnemius  and  soleus,  and  the  heel  is  jerked  up.  (2) 
Ankle  clonus;  if  the  half -extended  leg  be  supported  at  the 
knee,  and  the  ball  of  the  foot  be  suddenly  pressed  up, 
putting  the  tendo  Achillis  on  a  stretch,  in  certain  instances 
there  results  a  series  of  clonic  contractions  of  the  calf- 
muscles  with  consequent  alternate  extension  and  flexion 
of  the  foot,  which  continues  as  long  as  the  pressure  is 
maintained  on  the  ball  of  the  foot  and  ceases  as  soon  as 
the  foot  is  released  from  pressure.     (3)  Patellar  Reflex 


109  PHYSIOLOGY  AND  HYGIENE. 

(knee-jerk);  when  the  thigh  is  supported  by  the  hand  or 
by  being  crossed  over  the  other  thigh,  and  the  leg  is  flexed 
at  the  knee,  thus  securing  relaxation  of  the  quadriceps 
extensor,  a  tap  on  the  tendon  just  below  the  patella  causes 
the  leg  to  be  suddenly  extended.  (4)  Triceps  Reflex  (elbow- 
jerk);  this  is  analogous  to  the  knee-jerk  and  is  elicited  by 
supporting  the  arm  in  the  hand,  on  the  examiner's  knee, 
or  by  leaning  on  a  table,  the  forearm  being  somewhat 
flexed,  and  then  tapping  the  triceps  tendon  just  above  the 
olecranon."     (Hall's  Text-hook  of  Physiology.) 

4.7s.  Give  illustrations  of  morbid  reflex  action.  (April , 
1898.) 

475.  The  ankle  clonus  [see  A.  474  (b)]  is  probably  never 
present  in  health.  Other  instances  of  morbid  reflex  action 
can  be  seen  in  tetanus,  when  a  slight  touch,  or  even  a 
breath  of  air,  on  the  skin,  may  cause  convulsions  of  the 
whole  body;  also  in  the  vomiting  of  pregnancy. 

476.  What  are  the  functions  of  the  spinal  cord?  (No- 
vember, 1892.) 

477.  What  are  the  functions  of  the  spinal  cord?  (Sep- 
tember, 1899.) 

478.  What  are  the  functions  of  the  spinal  cord?  (Sep- 
tember, 1900.) 

479.  What  are  the  functions  of  the  spinal  cord?  (June, 
1895.) 

476  to  479.  Collins  and  Rockwell's  Physiology,  page  178. 

480.  Describe  the  functions  of  spinal  nerves.  (March, 
1893.) 

481.  What  are  the  respective  functions  of  the  anterior  and 
of  the  posterior  cornua  of  the  spinal  cord?    (June,  1896.) 

482.  State  the  function  of  the  anterior  spinal  nerve  roots. 
How  is  this  function  proved?     (April,  1898.) 

480  to  482.  Collins  and  Rockwell's  Physiology,  pages 
176  to  178. 

483.  To  what  extent  is  the  spinal  cord  an  independent 
nerve  centre?    (June,  1892.) 


13 


110  PHYSIOLOGY  AND  HYGIENE. 

483.  ^'The  efferent  cells  of  the  spinal  segments  are  the 
immediate  sources  of  the  nerve  energy  which  excites 
activity  in  muscles,  bloodvessels,  glands.  The  discharge 
of  their  energy  may  be  caused:  (1)  By  variations  in  the 
composition  of  the  blood  or  lymph  by  which  they  are 
surrounded.  The  activity  of  the  cell  thus  occasioned  is 
termed  automatic  or  autochthonic.  (2)  By  the  arrival  of 
nerve  energy  coming  through  afferent  nerves  from  the 
general  sentient  periphery,  skin,  mucous  membrane,  etc. 
(3)  By  the  arrival  of  nerve  energy  descending  the  spinal 
cord  from  the  cerebrum  or  subordinate  structures.  The 
peripheral  activity  in  the  former  instance  is  said  to  be 
reflex  or  peripheral  in  origin;  in  the  latter  instance,  direct 
or  cerebral  in  origin.  In  this  latter  instance,  also,  the 
muscle  movements  are  due  to  volitional,  the  vascular 
variations  and  glandular  discharges  to  emotional,  forms  of 
cerebral  activity.  Each  segment  of  the  spinal  cord  may 
be  regarded,  therefore,  because  of  its  contained  nerve-cells : 
(1)  As  a  centre  for  automatic  activity.  (2)  As  a  centre  for 
the  reception  of  excitations  arising  either  at  the  periphery 
or  in  the  cerebrum,  and  for  their  subsequent  transmission 
through  efferent  nerves  to  various  peripheral  organs.'' 
(Brubaker's  Text-hook  of  Physiology.) 

484-  Describe  the  effect  of  a  transverse  section  of  the  spinal 
cord  in  the  mid-dorsal  region.     (March,  1893.) 

484.  ''A  total  transverse  lesion,  destroying  absolutely 
one  segment  of  the  cord,  will  result  in  the  following  symp- 
toms: (1)  Paralysis  of  the  muscular  area  supplied  by  the 
destroyed  segment,  followed  by  rapid  atrophy,  reaction  of 
degeneration,  and  loss  of  reflexes  in  this  particular  group 
of  muscles.  (2)  Paralysis  of  all  the  muscles  supplied  by 
the  segments  below  that  which  has  been  destroyed.  The 
trophic  conditiofi  remains  normal,  at  any  rate,  for  a  time; 
but  when  secondary  descending  degeneration  in  the  antero- 
lateral columns  has  occurred,  the  muscles  become  con- 
tracted, tense,  and  rigid  (late  rigidity).    The  condition  of 


Ill  PHYSIOLOGY  AND  HYGIENE. 

the  reflexes  after  a  total  transverse  lesion  has  been  a  fertile 
source  of  discussion,  but  it  is  now  maintained  that  the 
deep  reflexes  are  entirely  and  permanently  lost,  whilst  the 
superficial  reflexes,  though  absent  for  a  time,  may  reappear. 

(3)  Complete  anaesthesia  of  the  sensitive  area  supplied  by 
the  destroyed  segment,  and  of  all  the  sensitive  areas  below. 

(4)  A  narrow  zone  of  hypersesthesia  is  found  at  the  upper 
level  of  the  anaesthetic  area,  due  to  irritation  of  the  nerve 
roots  at  the  site  of  injury.  (5)  Vasomotor  paralysis  com- 
bined with  trophic  disturbances  in  the  parts  which  are 
paralyzed.  (6)  Visceral  changes,  especially  in  the  bladder 
and  rectum."  (Incontinence  of  urine,  following  over- 
distention  of  the  bladder;  and  either  constipation  or 
incontinence  of  feces.)  (Rose  and  Carless,  Manual  of 
Surgery.) 

485.  What  would  he  the  effect  of  a  transverse  section  of 
(a)  the  anterior  root  of  a  spinal  nerve,  (b)  the  posterior  root 
of  a  spinal  nerve  f     (May,  1901.) 

486.  What  would  he  the  effect  of  dividing  the  posterior  root 
of  a  spinal  nerve  external  to  the  ganglion?    (Novemher,  1892.) 

485  and  486.  Collins  and  Rockwell's  Physiology,  pages 
177  and  178. 

487.  (a)  Descrihe  the  action  of  the  vasomotor  nerves.  (No- 
vember, 1893.) 

488.  What  effects,  if  any,  result  from  the  division  of  (b) 
a  vasoconstrictor  nerve,  (c)  a  vasodilator  nerve?    (May,  1900.) 

487  and  488.  (a)  Collins  and  Rockwell's  Physiology, 
pages  66  to  68.  (b)  In  division  of  a  vasoconstrictor  nerve 
the  vasoconstrictor  influence  is  interrupted  and,  therefore, 
there  will  be  dilatation  of  the  bloodvessels  supplied  by  the 
vasoconstrictor  nerve,  with  rise  of  temperature  in  the  parts 
nourished  by  those  bloodvessels,  (c)  In  division  of  a  vaso- 
dilator nerve  the  effects  produced  are  neither  definite  nor 
constant. 

489.  Name  the  principal  centres  of  organic  function  in 
the  medulla  oblongata      (April,  1894-) 


112  PHYSIOLOGY  AND  HYGIENE, 

489.  Collins  and  RockwelFs  Physiology,  pages  188  and 
189. 

2.  The  Cranial  Nerves. 

490.  What  is  the  function  of  (a)  the  optic  nerve,  (b)  the 
trochlear  nerve  f     (May,  1901.) 

490.  (a)  The  optic  nerve  is  the  special  nerve  of  the  sense 
of  sight,  (b)  The  trochlear  nerve  is  the  motor  nerve  of 
the  superior  oblique  muscle  of  the  eye. 

491.  Give  (a)  the  foramen  of  exit,  (b)  the  distribution,  and 
(c)  function  of  the  oculomotor  nerve.     (June,  1897.) 

492.  (c)  State  the  function  of  the  third  cranial  nerve,  (d) 
What  is  the  effect  of  division  of  the  third  cranial  nerve?  {June, 
1900.) 

491  and  492.  (a)  The  sphenoidal  fissure;  (b)  Collins  and 
Rockwell's  Physiology,  page  207;  (c)  page  207;  (d)  page 
207. 

493.  Give  (a)  the  foramen  of  exit,  (b)  the  distribution,  and 
(c)  the  function  of  the  pathetic  {fourth  cranial)  nerve.  {Sep- 
tember, 1897.) 

493.  (a)  The  sphenoidal  fissure;  (b)  Collins  and  Rock- 
well's Physiology,  page  208;  (c)  page  208,  and  see  Q. 
490  (b). 

494.  State  the  functions  of  the  fifth  cranial  nerve.  {May, 
1900.) 

494.  Collins  and  Rockwell's  Physiology,  page  208. 

495.  Give  the  origin  and  function  of  the  sixth  {abducens) 
nerve.    {May,  1895.) 

495.  Collins  and  Rockwell's  Physiology,  page  211. 

496.  What  would  be  the  effect  of  paralysis  of  the  seventh 
cranial  nerve  {portio  dura)  on  the  right  side?  {January^ 
1902.) 

496.  Collins  and  Rockwell's  Physiology,  page  213. 

497.  What  is  the  function  of  the  glossopharyngeal  nerve  f 
{January,  1895.) 


113  PHYSIOLOGY  AND  HYGIENE. 

497.  Collins  and  RockwelFs  Physiology,  page  215. 

498.  What  is  the  function  of  the  par  vagum?  (April ^ 
1897.) 

499.  What  are  the  functions  of  the  pneumogastric  nerve? 
(March,  1892.) 

500.  What  are  the  functions  of  the  pneumogastric  nerves? 
(July,  1893.) 

498  to  500.  Collins  and  Rockwell's  Physiology,  pages 
216  to  219. 

601.  What  is  the  function  of  the  superior  laryngeal  nerves? 
(April,  1895.) 

501.  The  superior  laryngeal  nerve  is  the  nerve  of  sensa- 
tion to  the  upper  part  of  the  larynx,  also  the  motor  nerve 
to  the  cricothyroid.  Hence,  with  loss  of  sensation  in  the 
larynx  there  is  also  loss  of  voice  production.  This  nerve 
also  protects  the  larynx  from  the  entrance  of  foreign  bodies. 

502.  Which  of  the  cranial  nerves  are  nerves  of  special 
sense?  Give  the  origin  and  function  of  each  nerve  mentioned. 
(June,  1902.) 

502.  Collins  and  Rockwell's  Physiology,  pages  206,  230, 
253,  238,  208  and  215.    See  also  Q.  490,  494  and  497. 

503.  (a)  What  is  the  cerebrospinal  system  of  nerves  and 
(b)  to  what  parts  of  the  body  are  its  fibres  chiefly  distributed? 
(September,  1901.) 

503.  (a)  Collins  and  Rockwell's  Physiology,  page  169; 
(b)  To  the  voluntary  muscles,  the  organs  of  sense,  skin, 
and  other  parts  endowed  with  sensibility. 

3.  The  Cerebrum. 

504.  What  are  the  functions  of  the  brain  membranes? 
(January,  1897.) 

504.  ''The  dura  mater,  by  its  outer  layer,  acts  as  a 
periosteum;  by  its  inner  layer  as  a  lymph  sac.    It  is  also, 


114  PHYSIOLOGY  AND  HYGIENE. 

by  virtue  of  its  sensitiveness,  a  protection  against  injury 
and  disease.  The  arachnoid  forms  the  inner  wall  of  the 
lymph  sac.  The  pi  a  mater  is  a  vascular  and  nutritive 
organ.  It  is,  however,  also  closely  connected  with  the 
lymphatic  system  of  the  arachnoid. ''  (Dana's  Text-hook 
of  Nervous  Diseases.) 

505.  Give  (a)  the  composition  and  (b)  uses  of  cerebrospinal 
fluid.    (January,  1896.) 

505.  (a) 

"Water 987.00 

Albumin 1.10 

Fat 0.09 

Cholesterin 0.21 

Alcoholic  and  aqueous  extract,  minus  salts')  ^  jk 

Sodium  lactate f 

Chlorides 6.14 

Earthy  phosphates 0.10 

Sulphates 0.20 

'^In  addition  urea  is  at  times  found,  as  also  a  substance 
which  reduces  Fehling's  solution  and  gives  rise  to  a  brown 
color  when  boiled  with  caustic  potash,  but  which  neither 
imdergoes  fermentation  nor  forms  an  osazone  when  treated 
with  phenylhydrazin.  The  substance  in  question  is  gener- 
ally regarded  as  pyrocatechin."  (Simon's  Clinical  Diag- 
nosis.) (b)  '^The  cerebrospinal  fluid  forms  a  water  bed 
on  which  rests  the  base  of  the  middle  and  posterior  parts 
of  the  encephalon.  It  performs  an  important  function  in 
protecting  the  brain  from  injury  and  the  circle  of  Willis 
from  compression.  It  also  helps  to  dissipate  the  force  of 
a  blow,  so  that  less  injury  is  done  at  the  point  of  its  recep- 
tion."   (Reference  Handbook  of  the  Medical  Sciences.) 

506.  What  are  the  effects  of  removal  of  the  cerebrum  in 
the  lower  animals?     (September,  1895.) 

506.  Collins  and  Rockwell's  Physiology,  page  206. 


115  PHYSIOLOGY  AND  HYGIENE. 

507.  (a)  What  is  the  function  of  the  gray  matter  of  the 
brain  f     (September,  1896.) 

608.  Describe  (a)  the  offices  and  (b)  the  characteristics  of 
the  gray  matter  of  the  brain.    {June,  1894.) 

509.  What  differences  of  function  exist  between  the  (c) 
white  and  (a)  gray  matter  of  the  encephalonf  {January,. 
1894.) 

510.  What  are  the  functions  of  the  (c)  white  and  (a)  gray 
matter  of  the  brain  f    {January,  1892.) 

507  to  510.  (a)  Collins  and  Rockwell's  Physiology,  page 
198;  (b)  pages  195  and  196;  (c)  pages  193  and  197. 

511.  What  portion  of  the  cerebrum  comprises  the  motor 
area?  {January,  1896.) 

512.  Describe  the  motor  area  of  the  human  brain.  {April, 
1893.) 

511  and  512.  Collins  and  RockwelFs  Physiology,  pages 
199  and  200. 

513.  (a)  Where  is  the  visual  centre  located?    {March,  1893.) 

514.  Locate  in  the  brain  the  seat  of  (a)  sight,  (b)  hearing. 
{June,  1893.) 

515.  Locate  in  the  brain  the  seat  of  the  special  sense  (a) 
of  sight,  (b)  of  hearing,  (c)  of  smell.    {April,  1896.) 

513  to  515.  (a)  Collins  and  RockwelFs  Physiology,  page 
199 ;  (b)  page  199 ;  (c)  in  the  uncinate  gyrus,  and  the 
fornicate  gyrus. 

516.  (a)  What  is  the  location  of  the  centre  for  articulate 
speech?    {January,  1893.) 

517.  Where  is  the  centre  of  (a)  speech,  (b)  respirationf 
{May,  1897.) 

516  and  517.  (a)  Collins  and  Rockwell's  Physiology,, 
page  199;  (b)  page  86. 

4.  Sleep. 

518.  (a)  Give  a  physiological  explanation  of  sleep.  What 
is  the  condition  of  the  brain  during  sleep?    {June,  1896.) 


116  PHYSIOLOGY  AND  HYGIENE. 

519.  (a)  Describe  the  'phenomena  of  sleep.  {November^ 
1893.) 

520.  (b)  Enumerate  the  physiological  advantages  of  natural 
sleep;  and  (c)  state  at  what  period  of  life  the  least  sleep  is 
required?     (June,  189  4.) 

518  to  520.  (a)  See  A.  195  to  203  (f);  (b)  (1)  entire  rest 
to  the  whole  body;  (2)  restitution  of  the  energy  that  has 
been  expended  during  the  time  of  work  and  wakefulness; 
(3)  removal  of  waste  products  of  muscular  metabohsm. 
(c)  The  least  sleep  is  required  in  adult  life,  from  about 
twenty-five  years  of  age  to  fifty;  at  this  period  seven  hours 
in  the  twenty-four  are  all  that  is  generally  requisite,  and 
many  people  require  only  five. 

521.  What  are  the  physiological  causes  of  (a)  sleep,  (b) 
dreams?     {June,  1901.) 

521.  (a)  See  A.  195  to  203  (f).  (b)  ''After  sleep  has 
supervened  there  are  many  gradations  in  its  depth  and 
character.  In  some  cases  it  may  be  so  light  that  the 
individual  is  partly  conscious  of  external  impressions  and 
of  the  disordered  trains  of  thought  and  feeling  that  pass 
through  his  mind,  constituting  dreams,  and  these  may  be 
more  or  less  vivid  according  to  the  degree  of  consciousness 
remaining.  On  the  other  hand,  the  sleep  may  be  so 
profound  as  to  abolish  all  psychical  phenomena;  there  are 
no  dreams,  and  when  the  sleeper  awakes  the  time  passed 
in  this  unconscious  state  is  a  blank.  The  first  period  of 
sleep  is  the  most  profound.  After  a  variable  period^ 
usually  from  five  to  six  hours  of  deep  sleep,  the  faculties 
awaken,  not  simultaneously,  but  often  fitfully,  so  that 
there  are  transient  periods  of  consciousness.  This  is  the 
time  of  dreaming.  As  the  period  of  waking  approaches 
the  sensibility  becomes  more  acute,  so  that  external 
impressions  are  faintly  perceived.  These  impressions  may 
influence  and  mould  the  flow  of  images  in  the  mind  of  the 
sleeper,  frequently  altering  the  nature  of  his  dreams  or 
making  them  more  vivid Dreams  only  occur 


117  PHYSIOLOGY  AND  HYGIENE. 

when  sleep  is  light,  and  they  indicate  that  consciousness 
is  still  continued.  The  characteristic  feature  of  dreaming 
is  that  the  mind  has  no  control  over  the  groups  of  images 
that  crowd  upon  it.  These  images  are  either  revivals  of 
old  sensory  impressions  that  have  been  stored  up  in  the 
brain  or  they  are  the  result  of  an  untrammelled  imagina- 
tion. The  will  has  lost  the  power  of  direction  and  control; 
ideas,  often  grotesque,  always  confused,  rise  apparently 
spontaneously,  are  vivid  for  an  instant,  and  then  disappear. 
Dreaming  may  be  described  as  a  kind  of  physiological 
delirium."    (Encyclopcedia  Britannica,  vol.  xxii.) 

622.  Define  somnambulism,  from  a  physiological  point  of 
view.    {J  line,  1900.) 

522.  '^  1.  The  condition  of  half -sleep,  in  which  the  senses 
are  but  partially  suspended;  also  sleep-walking,  a  condition 
in  which  the  individual  walks  during  sleep.  2.  The  type 
of  hypnotic  sleep,  in  which  the  subject  is  possessed  of  all 
his  senses,  often  having  the  appearance  of  one  awake, 
but  whose  will  and  consciousness  are  under  the  control  of 
the  hypnotizer."     (Gould's  Medical  Dictionary.) 

523.  What  is  hypnotism?  What  constitutes  susceptibility 
in  an  hypnotic  subject?    (January,  1899.) 

523.  '^A  state  of  artificial  somnambulism  or  trance, 
induced  in  certain  persons  by  concentrating  the  gaze  on 
a  small  object,  or  on  a  revolving  mirror,  or  by  complete 
subjection  of  their  will  to  that  of  another,  at  whose  com- 
mand the  hypnotic  stage  develops.  Three  stages  are 
described — the  cataleptic,  the  lethargic,  and  the  somnam- 
bulistic." (Gould's  Medical  Dictionary.)  '^Hypnosis  is 
nothing  more  than  the  intentional  artificial  production  of 
a  hysterical  attack,  or  a  hysterical  psychosis  by  suggestion 
— that  is,  by  the  action  of  definite  ideas  on  the  person  to 
be  hypnotized.  Therefore,  only  those  persons  can  be 
hypnotized  in  whom  these  ideas  have  a  strong-enough 
influence.    No  man  can  be  hypnotized  to  whom  the  nature 


14 


118  PHYSIOLOGY  AND  HYGIENE. 

of  hypnosis  is  clear.  The  essential  feature  of  all  hypnotic 
procedures  is  merely  to  produce  in  the  most  lively  way 
possible  the  idea,  'It  will  happen  as  the  hypnotizer  says/ 
All  other  things — the  fixation  of  the  eyes  on  bright  objects, 
the  vibrations  of  a  tuning-fork,  etc. — are  side  issues,  and 
are  merely  to  support  the  suggestion."  (Striimpell,  Practice 
of  Medicine.) 

524.  What  is  unconscious  cerebration?    {March,  1892.) 

524.  By  unconscious  cerebration  is  meant  an  unconscious 
exercise  of  the  mind  during  sleep  or  mental  occupation. 
(Dunglison's  Medical  Dictionary.) 

5.  The  Cerebellum. 

525.  Describe  the  junctions  of  the  cerebellum.  {June,. 
1892.) 

526.  What  are  the  functions  of  the  cerebellum?  {May, 
1893.) 

527.  What  is  the  function  of  the  cerebellum?  {January,. 
1898.) 

525  to  527.  Collins  and  Rockwell's  Physiology,  page  203. 

6.  The  Sympathetic  System. 

528.  What  are  the  functions  of  the  main  sympathetic 
ganglia?     {November,  1894.) 

529.  Give  the  varied  functions  of  the  sympathetic  nerve. 
{September,  189  Jf.) 

530.  What  is  the  function  of  the  great  sympathetic  nerve? 
{January,  1898.) 

531.  State  the  functions  of  the  sympathetic  nerves.  {Sep- 
tember, 1902.) 

532.  What  are  the  functions  of  the  great  sympathetic  nerve? 
{May,  1893.) 

528  to  532.  Collins  and  Rockwell's  Physiology,  page  173- 


119  PHYSIOLOGY  AND  HYGIENE. 

XII.  THE  SENSES. 
1.  Common  Sensations. 

5S3.  Describe  the  physiology  of  pain.    (September,  1893.) 
634.  How  is  the  sensation  of  pain  produced?    (January, 
1893.) 

533  and  534.  ^' As  regards  painful  sensations,  three  views 
can  be  taken:  (1)  that  it  is  a  special  sensation  provided 
with  a  special  conducting  apparatus  in  each  part  of  the 
body;  (2)  that  it  is  produced  by  an  overstimulation  of  the 
special  nerves  concerned  with  touch  or  temperature,  or  of 
the  other  nerves  of  special  sense;  or  (3)  that  it  is  an  over- 
stimulation of  the  nerves  of  common  sensation,  which  tell 
us  of  the  condition  of  our  own  bodies,  both  of  the  surface 
a,nd  of  the  internal  organs.  There  seems  to  be  much  in 
favor  of  all  these  views.  The  weight  of  evidence  is,  however, 
rather  against  there  being  any  special  pain  sense  with  a 
special  end-organ  and  fibres.  It  is,  however,  certain  that, 
even  if  any  variety  of  pain  be  a  special  sensation,  some 
kind  of  pain  may  be  produced  by  stimulation  of  the  bare 
sensory  nerves  apart  from  any  special  form  of  nerve 
termination."  (Kirkes'  Handbook  of  Physiology.)  And 
see  Collins  and  Rockwell's  Physiology,  page  221. 

535.  Give  the  physiology  of  (1)  hunger,  (2)  thirst.  (Sep- 
tember, 1897.) 

535.  '^Himger  and  thirst  are  peculiar  sensations  which 
depend  partly  on  local  and  partly  on  general  causes. 
Diminution  in  the  bulk  of  water  and  of  circulating  aliment 
in  the  body  no  doubt  causes  excitement  of  sensory  nerves 
on  which  depend  the  feelings  of  thirst  and  hunger,  but  in 
ordinary  life  these  feelings  are  dependent  on  the  physical 
condition  of  certain  mucous  surfaces.  Any  circumstance 
which  causes  drying  of  the  lining  membrane  of  the  mouth 
provokes  thirst,  and  some  condition  of  the  empty  stomach 
arouses  hunger.  Thirst  may  be  assuaged  by  introducing 
water  directly  into  the  stomach  through  a  gastric  fistula, 


120  PHYSIOLOGY  AND  HYGIENE. 

though  to  effect  the  purpose  a  larger  quantity  must  be 
employed  in  this  way  than  by  the  mouth.  Hunger  in  a 
somewhat  similar  manner  may  be  appeased  by  rectal 
alimentation.  It  seems  probable,  however,  that  these 
sensations  as  usually  felt  are  the  result  of  a  sort  of  habit, 
depending  on  the  physiological  condition  of  the  secreting 
and  absorbing  mechanisms  of  the  alimentary  canal." 
(American  Text-hook  of  Physiology.) 

2.  Special  Sensations. 

S36.  Name  the  organs  of  the  special  senses.    (May,  1893.) 

536.  Collins  and  Rockwell's  Physiology,  pages  222,  225, 
229,  232  and  243. 

537.  Describe  the  sense  of  feeling  and  explain  how  it  is 
produced.     (March,  1892.) 

537.  Collins  and  Rockwell's  Physiology,  page  222. 

538.  (a)  What  conditions  are  necessary  for  properly 
exercising  the  sense  of  smell?    (September,  1895.) 

539.  (b)  Describe  the  olfactory  apparatus,  (c)  What  part 
of  the  olfactory  apparatus  is  the  seat  of  smell?  (January, 
1899.) 

540.  (d)  What  is  the  function  of  the  Schneiderian  (pitui- 
tary) membrane?    (May,  1894.) 

538  to  540.  (a)  Collins  and  Rockwell's  Physiology,  page 
229;  (b)  page  230;  (c)  the  Schneiderian  membrane;  (d) 
it  is  the  seat  of  the  sense  of  smell. 

541 '  (a)  Describe  the  mechanism  of  hearing.  (March, 
1893.) 

542.  (a)  Give  the  mechanism  of  the  organs  of  hearing. 
(November,  1892.) 

543.  (a)  How  are  auditory  sensations  produced?  (No- 
vember, 1894') 

544'  (^  How  is  the  sensation  of  sound  conveyed  to  the 
brain?     (January,  1900.) 


121  PHYSIOLOGY  AND  HYGIENE. 

54s.  (b)  Explain  in  detail  how  the  functions  of  the 
auditory  organs  are  performed.     {June,  1902.) 

541  to  545.  (a)  Collins  and  Rockwell's  Physiology,  page 
239;  (b)  pages  233  to  240. 

546.  (a)  What  office  does  the  Eustachian  tube  perform? 
{June,  1897.) 

5Jf.7.  (a)  State  the  physiological  purpose  of  the  Eustachian 
tube.     {September,  1899.) 

548.  (b)  What  effect  on  hearing  has  the  closing  of  the 
Eustachian  tube?     {January,  1894.) 

546  to  548.  (a)  Collins  and  RockwelFs  Physiology,  page 
235.  (b) ' '  When  constriction  of  the  tube  takes  place,  so  that 
the  air  does  not  enter  the  tympanum  except  with  difficulty, 
the  result  is  that  the  drumhead  and  ossicles  are  forced 
inward  and  congestion  of  the  middle  ear  occurs,  followed 
by  adhesions  and  deafness,  if  not  relieved."  (Bacon's 
Manual  of  Otology.) 

549.  How  and  why  is  hearing  affected  by  rupture  of  the 
membrana  tympani?     {September,  1896.) 

6 SO.  What  effect  on  hearing  has  the  perforation  of  the 
membrana  tympani,  and  how  is  it  explained?  {January,  1893.) 

549  and  550.  The  acuteness  of  hearing  is  considerably 
diminished;  this  is  due  to  the  lessened  capacity  for  vibra- 
tion produced  by  the  rupture  of  the  membrana  tympani. 
It  has  been  asserted,  however,  that  ''an  opening  in  it,  or 
even  its  total  loss,  may  hardly  impair  the  hearing  to  a 
perceptible  degree."     (Randall.) 

551.  Explain  the  phenomena  and  causation  of  auditory 
vertigo  or  Meniere's  disease.     {April,  1896.) 

551.  ''Under  the  term  Meniere's  disease  is  grouped  a 
class  of  cases  in  which  vertigo  is  caused  by  perversion  or 
abeyance  of  the  labyrinthine  function.  The  labyrinthine 
disturbance  may  be  caused  either  (1)  directly  by  an  affection 
of  the  labyrinth,  such  as  (a)  hemorrhage,  (b)  congestion  and 
inflammation;  or  (2)  indirectly,  by  {a)  disease  of  the  middle 


122 


PHYSIOLOGY  AND  HYGIENE. 


ear  (otitis  media),  (h)  obstruction  of  the  Eustachian  tube, 
(c)  spasm  of  the  tensor  tympani,  or  paralysis  of  the  stape- 
dius, or  (d)  irritation  or  obstruction  of  the  external  auditory 
meatus,  and  pressure  on  the  membrana  tympani,  as  by 
cerumen,  foreign  bodies,  or  by  syringing  the  ears,  especially 
when  the  membrana  tympani  is  perforated.  In  Meniere's 
disease,  strictly  speaking,  there  is  always  coincident  affec- 
tion of  the  semicircular  canals  and  cochlea,  as  indicated 
by  the  three  most  important  associated  symptoms :  vertigo, 
tinnitus,  and  deafness.  Accompanying  these  cardinal 
symptoms  there  are  accessory  phenomena,  due  to  secondary 
visceral  disturbance,  namely,  pallor,  faintness,  and  nausea 
or  vomiting — a  condition  of  syncope."  (Quain's  Dictionary 
of  Medicine.) 

552.  What  are  the  movements  of  the  eyeball?    Mention  the 
muscles  concerned  in  each  of  these  movements.    {June,  1900.) 
552.  Action  of  ocular  muscles: 


Number  of  Muscles 
Acting. 


One 
Two 


Three, 


Direction- 


Inward 
Outward 

Upward 

Downward 

Inward  and 
upward 

Inward  and 
downward 

Outward  and 
upward 

Outward  and 
downward 


Muscles  Acting. 


Internal 
External 
f  Superior 
\  Inferior 
f  Inferior 
\  Superior 

{Internal 
Superior 
Inferior 
Internal 
Inferior 
Superior 

{External 
Superior 
Inferior 
External 
Inferior 
Superior 


pectus. 

rectus. 

rectus. 

oblique. 

rectus. 

oblique. 

rectus. 

rectus. 

oblique. 

rectus. 

rectus. 

oblique. 

rectus. 

rectus. 

oblique. 

rectus. 

rectus. 

oblique. 


(Chapman's  Human  Physiology.) 


123  PHYSIOLOGY  AND  HYGIENE. 

553.  (a)  Name  the  refracting  media  of  the  eye  and  the  effect 
that  each  has  on  the  rays  of  light.    (January,  1893.) 

554.  (b)  State  the  function  of  the  aqueous  humor  of  the 
eye.     (September,  1902.) 

553  and  554.  (a)  Collins  and  Rockwell's  Physiology, 
pages  245  to  249;  (b)  page  247. 

555.  Give  the  nervous  and  muscular  mechanism  of  the 
dilation  and  contraction  of  the  pupil  of  the  eye.    (May,  1902.) 

556.  Account  for  the  contraction  and  dilatation  of  the 
pupil.     (April,  189Jf..) 

557.  Explain  the  contraction  of  the  pupil  of  the  eye, 
(May,  1897.) 

555  to  557.  Collins  and  Rockwell's  Physiology,  page  248. 

558.  (a)  How  is  accommodation  in  the  eye  accomplished? 
(b)  What  is  color-blindness?     (September,  1900.) 

559.  (c)  How  are  the  sensations  of  color  produced?  (July, 
1893.) 

560.  (b)  Describe  color-blindness  and  name  the  colors 
which  the  subject  commonly  fails  to  distinguish.  (January, 
1897.) 

558  to  560.  (a)  Collins  and  Rockwell's  Physiology,  page 
250;  (b)  pages  262  and  264;  (c)  page  262. 

561.  (a)  Describe  the  rods  and  cones  of  the  retina.  (Janu- 
ary, 1901.) 

562.  (b)  State  the  function  of  the  retina.    (January,  1900.) 
561   and  562.  (a)  Collins  •  and  Rockwell's  Physiology, 

page  251;  (b)  pages  250  and  251. 

563.  (a)  What  is  the  condition  of  the  eyeball  in  myopia? 
How  may  it  be  corrected?    (January,  1900.) 

564.  Define  (a)  myopia,  (b)  hypermetropia,  (c)  astigma- 
tism. State  the  cause  of  each  of  these  conditions.  (May, 
1899.) 

563  and  564.  (a)  Collins  and  Rockwell's  Physiology,  page 
260;  (b)  page  261;  (c)  page  262. 


124  PHYSIOLOGY  AND  HYGIENE. 

XIII.  THE  REPRODUCTIVE  ORGANS. 

1.  Female. 

565.  (a)  Describe  menstruation.     (June,  1901.) 

566.  (a)  Give  the  physiology  of  menstruation.  {May^ 
1897.) 

567.  (a)  Give  the  physiology  of  menstruation,  and  (b) 
describe  the  menopause.    {June,  1899.) 

568.  (b)  What  changes  take  place  in  the  reproductive 
organs  at  the  climacteric  period?    {September,  1893.) 

569.  (c)  What  is  the  average  duration  of  menstrual  life? 
{June,  1894.) 

565  to  569.  (a)  Collins  and  Rockwell's  Physiology,  pages 
273  and  274;  (b)  page  274;  (c)  page  274. 

570.  Where  does  the  human  ovum  originate?  Describe  the 
progress  of  the  human  ovum  from  origin  to  final  disposition. 
{May,  1900.) 

571.  Trace  the  ovum  in  its  course  from  the  ovary  to  the 
uterus,  and  give  the  changes  that  take  place  in  it  in  impreg- 
nation.    {January,  1894.) 

570  and  571.  Collins  and  Rockwell's  Physiology,  pages 
275  to  277. 

572.  Describe  the  process  of  segmentation  of  the  ovum. 
{September,  1894.) 

572.  Collins  and  Rockwell's  Physiology,  pages  282  to 
284. 

573.  Give  the  present  physiological  conclusions  in  respect 
to  the  presence  of  the  corpus  luteum  as  a  sign  of  pregnancy. 
{January,  1897.) 

573.  Collins  and  Rockwell's  Physiology,  pages  276  and 

277. 

574.  What  is  the  earliest  period  of  gestation  at  which  the 
sounds  of  the  fetal  heart  may  be  reliably  heard?    {June,  1896.) 

574.  ''The  pulsation  of  the  fetal  heart  can  seldom  be 
heard  before  the  twentieth  week  (the  middle  of  pregnancy). 


125  PHYSIOLOGY  AND  HYGIENE. 

A  practised,  skilful  ear  may  recognize  it  two  or  three  weeks 
earlier."     (King's  Manual  of  Obstetrics.) 

575.  Whence  are  derived  the  motor  impulses  of  labor? 
{January,  1894.) 

575.  Collins  and  Rockwell's  Physiology,  page  306. 

576.  (a)  Describe  the  placenta  and  its  membranes,  (b) 
Give  the  function  of  the  placenta.    {January,  1895.) 

576.  (a)  Collins  and  Rockwell's  Physiology,  pages  289 
to  291.  ''The  placenta  at  full  term  is  a  soft,  spongy  mass, 
irregularly  saucer-shaped,  seven  or  eight  inches  in  diameter, 
three-quarters  of  an  inch  thick  near  the  centre,  and  from 
one-eighth  to  one-fourth  of  an  inch  at  the  edge;  average 
weight  twenty  ounces.  It  varies  much  in  all  these  par- 
ticulars."    (King's  Manual  of  Obstetrics.) 

(b)  *' Functions  of  the  Placenta.  It  not  only  affords 
nutriment  to  the  child,  but  is  also  its  respiratory  organ. 
The  umbilical  arteries  carry  blue  (venous)  blood  to  the 
placenta,  where  carbonic  acid  gas  is  given  off  to  the 
maternal  blood,  and  oxygen  taken  in  from  it,  so  that 
the  umbilical  vein  brings  back  arterial  (red)  blood  to  the 
foetus.  The  placenta  is  also  an  organ  of  excretion  for  the 
infant."     (King's  Manual  of  Obstetrics.) 

577.  Give  the  process  of  regeneration  of  uterine  mucous 
membrane  following  pregnancy.     {January,  1895.) 

577.  ''After  birth  the  thick  muscular  mass  decreases  in 
size,  some  of  its  fibres  undergoing  fatty  degeneration. 
Within  the  lumen  of  the  bloodvessels  of  the  uterus  itself 
there  begins  in  the  interna  of  these  vessels  a  proliferation 
of  the  connective-tissue  elements,  whereby  within  a  few 
months  the  bloodvessels  so  affected  become  completely 
occluded.  The  smooth  muscular  fibres  of  the  middle  coat 
of  the  arteries  undergo  fatty  degeneration.  The  relatively 
large  vascular  spaces  in  the  region  of  the  placenta  are  filled 
by  blood  clots,  which  are  ultimately  traversed  by  out- 
growths of  the  connective  tissue  of  the  vascular  walls." 
(Landois  and  Stirling's  Text-book  of  Human  Physiology.) 


15 


126  PHYSIOLOGY  AND  HYGIENE. 

2.  Male. 

678.  Describe  briefly  the  processes  of  the  phenomena  of 
reproduction.     {January,  1893.) 

578.  Collins  and  Rockwell's  Physiology,  pages  280  and 
281. 

579.  Give  the  physiology  of  the  male  sexual  organs.  (Sep- 
tember, 1895.) 

579.  Collins  and  Rockwell's  Physiology,  pages  277  to  280. 

580.  (a)  What  is  the  function  of  the  testes?    {March,  1893.) 

581.  (b)  How  is  the  descent  of  the  testicle  in  the  scrotum 
accomplished?     {January,  1899.) 

580  and  581.  (a)  Collins  and  Rockwell's  Physiology,  page 
278.  (b)  ''The  means  by  which  the  descent  of  the  testicles 
into  the  scrotum  is  effected  are  not  fully  and  exactly 
known.  It  was  formerly  believed  that  a  membranous  and 
partly  muscular  cord,  called  the  gubernaculum  testis,  which 
extends  while  the  testicle  is  yet  high  in  the  abdomen,  from 
its  lower  part,  through  the  abdominal  wall  (in  the  situation 
of  the  inguinal  canal)  to  the  front  of  the  pubes  and  the 
lower  part  of  the  scrotum,  was  the  agent  by  the  contraction 
of  which  the  descent  was  effected.  It  is  now  generally 
thought,  however,  that  such  is  not  the  case,  and  that  the 
descent  of  the  testicle  is  rather  the  result  of  a  general 
process  of  development  in  these  and  neighboring  parts, 
the  tendency  of  which  is  to  produce  this  change  in  the 
relative  position  of  the  organs.  In  other  words,  the  descent 
is  not  the  result  of  a  mere  mechanical  action,  by  which  the 
organ  is  dragged  down  to  a  lower  position,  but  rather  one 
change  out  of  many  which  attend  the  gradual  development 
and  rearrangement  of  the  organs.  It  may  be  repeated, 
however,  that  the  details  of  the  process  by  which  the 
descent  of  the  testicle  into  the  scrotum  is  effected  are  not 
accurately  known."     (Kirkes'  Physiology.) 

582.  (a)  What  is  the  composition  of  the  seminal  fluid f 
{June,  1893.) 


127  PHYSIOLOGY  AND  HYGIENE. 

585.  (b)  Describe  the  seminal  fluid,  and  (c)  explain  how 
it  is  conveyed  to  the  vesiculce  seminales.    {September,  1896.) 

584'  (c)  How  is  the  seminal  fluid  conveyed  to  the  vesiculce 
seminales  f     (September,  1892.) 

685.  (d)  Describe  spermatozoa  microscopically  and  physio- 
logically.    {January,  1900.) 

582  to  585.  (a) 

Water 90 

Albuminous  material  and  extractives     ...       6 
Mineral  material 4 

(b)  "Semen  is  white  or  slightly  yellowish  in  color,  semi- 
fluid, sticky,  and  of  an  opaque,  non-homogeneous,  milky 
appearance,  which  is  due  to  the  presence  of  white,  opaque 
islets  floating  in  the  otherwise  clear  fluid;  these  consist 
almost  entirely  of  the  specific  morphological  elements  of  the 
semen,  the  spermatozoa.  Its  odor,  strongly  resembling 
that  of  fresh  glue,  is  very  characteristic,  and  is  owing  to 
the  presence  of  spermin.  It  is  generally  attributed  to  an 
admixture  of  prostatic  fluid,  as  the  semen  obtained  from 

the  vasa  deferentia  is  odorless The  reaction 

of  human  semen  is  slightly  alkaline,  and  its  specific  gravity 
is  greater  than  that  of  water,  in  which  it  readily  sinks." 
(Simon's  Clinical  Diagnosis.)  (c)  Collins  and  RockwelFs 
Physiology,  page  278;  (d)  page  278. 

XIV.  MISCELLANEOUS. 

586.  What  is  the  physiology  of  the  so-called  rest-cure? 
{September,  1897.) 

587.  What  is  the  physiology  of  the  so-called  rest-cure? 
{January,  1899.) 

586  and  587.  "The  essential  feature  of  the  treatment  is 
rest.  This  promotes  growth  of  tissue  and  repair  of  waste. 
To  hasten  the  attainment  of  these  ends,  overfeeding  with 
easily  digested  food  is  required.    A  part  of  the  principle 


128  PHYSIOLOGY  AND  HYGIENE. 

of  true  rest  and  repose  is  seclusion.  In  order  to  counter- 
balance any  ill-effects  due  to  prolonged  rest  in  bed,  and 
to  assist  in  tissue  metabolism,  massage  and  the  exercise  of 
muscles  by  faradization  are  made  adjuncts  to  the  treat- 
ment. Hydrotherapy  is  frequently  employed  as  an  adjunct. 
.  .  .  .  Rest-cure  consists,  in  brief,  of  rest,  particular 
diet,  artificial  exercise,  and  isolation."  (Foster's  Practical 
Therapeutics.)  The  rest-cure  is  based  on  the  fact  that 
every  movement  of  the  body  involves  a  certain  amount  of 
muscular  energy,  and  the  object  of  the  cure  is  to  conserve 
that  energy. 

588.  Describe  the  physiological  process  by  which  the  bite  of 
a  venomous  snake  or  the  hypodermic  injection  of  the  virus 
causes  death.     (June,  1894.) 

588.  In  either  case  the  virus  reaches  the  tissues  under 
the  skin,  whence  it  is  taken  by  the  lymphatics  to  the 
thoracic  duct  or  right  lymphatic  duct,  and  is  thus  con- 
veyed into  the  venous  system  at  the  junction  of  the  sub- 
clavian and  internal  jugular  veins.  From  the  heart  it  is 
distributed,  by  the  systemic  circulation,  and  produces 
death  by  causing  perversion  of  function  of  one  or  more  of 
the  organs  or  tissues  with  which  it  comes  in  contact. 

589.  In  what  manner,  physiologically,  does  a  largely  dis- 
tended stomach  produce  death?    {November,  189 4.) 

589.  The  distention  of  the  stomach  may  cause  displace- 
ment of  the  heart,  and  by  mere  mechanical  pressure  could 
cause  arrest  of  circulation.  The  absorption  of  toxic 
products  arising  from  the  decomposition  going  on  in  the 
stomach  might  also  cause  death.  Hypertrophy  and  dilata- 
tion of  the  heart  caused  by  the  venous  stasis  due  to  press- 
ure can  be  followed  by  death. 

590.  Give,  with  reference  to  a  male  adult  aged  thirty-five^ 
(a)  average  weight  and  height,  (b)  average  lung  expansion^ 
(c)  average  abdominal  (waist)  measure.     (September,  1900.) 

590.  (a)  Taking  average  height  at  5  feet  9  inches,  the 


129  PHYSIOLOGY  AND  HYGIENE. 

weight  would  be  about  148  to  150  pounds;  (b)  about 
2  to  3  inches  expansion  (over  33  inches  on  expiration); 
(c)  about  28  or  29  inches. 

591.  Give  (a)  the  average  weight,  (b)  the  chest  expansion^ 
and  (c)  the  lung  capacity  of  an  adult  5  feet  6  inches  in  height. 
{April,  1897.) 

591.  (a)  About  132  pounds;  (b)  about  2  inches  (over 
32^  inches  on  expiration) ;  (c)  about  220  to  240  cubic  inches. 

592.  Give  the  (a)  average  normal  weight,  (b)  chest  measure- 
ment, (c)  chest  expansion,  and  (d)  girth  of  abdomen  of  a 
man  6  feet  in  height.     {September,  1896.) 

592.  (a)  About  169  pounds;  (b)  34f  inches  (on  expira- 
tion) ;  (c)  about  3  inches  (over  b) ;  (d)  about  29J  inches. 

593.  What  should  be  (a)  the  height,  (b)  weight,  and  (c) 
chest  measurement  of  a  typical  man  aged  25  years?  {Sep- 
tember, 1894.) 

593.  (a)  Taking  height  at  5  feet  8  inches,  (b)  weight 
should  be  about  140  to  142  pounds,  (c)  and  chest  measure- 
ment about  33  inches  (on  expiration). 

594.  State  what  are,  under  normal  conditions,  the  (a) 
adult  pulse  rate,  (b)  adult  number  of  respirations  per  minute, 
(c)  body  temperature,  and  (d)  average  respiratory  capacity. 
{April,  1894.) 

594.  (a)  About  72  per  minute;  (b)  about  18  per  minute; 
(c)  about  98.6°  F.  in  the  mouth;  (d)  about  225  to  250 
cubic  inches. 

595.  (a)  What  are  the  sources  of  income  for  the  body? 
{June,  1893.) 

596.  (b)  Through  what  organs  is  the  expenditure  or  waste 
of  the  body?     {September,  1893.) 

595  and  596.  (a)  Collins  and  Rockwell's  Physiology, 
page  137;  (b)  page  137. 

597.  Give  the  reactions  of  the  following  fluids,  and  state 
the  cause  of  the  reaction  in  each  case:  urine,  blood,  gastric 
juice,  and  pancreatic  juice.    {April,  1893.) 


130 


PHYSIOLOGY  AND  HYGIENE. 


597. 


Urine 

Blood     .      .      . 
Gastric  juice 
Pancreatic  juice 


Reaction. 


Acid 
Alkaline 
Acid 
Alkaline 


Cause. 


Acid  sodium  phosphate. 
Phosphates  and  carbonates  of  sodium. 
Hydrochloric  acid. 
Sodium  carbonate. 


598.  How  does  impairment  of  the  function  of  one  of  the 
following  affect  the  other  two:  (a)  the  skin,  (b)  the  lungs, 
(c)  the  kidneys?     {May,  1901.) 

598.  (a)  Impairment  of  the  function  of  the  skin  increases 
the  amount  of  water  and  COj  that  must  be  thrown  off  by 
the  lungs,  and  the  water  and  sohds  to  be  excreted  by  the 
kidneys,  (b)  Impairment  of  the  function  of  the  lungs 
causes  imperfect  oxidation  of  waste,  increasing  the  difficulty 
of  its  excretion  by  the  kidneys  and  skin,  with  consequent 
impairment  of  fimction  by  reason  of  irritation  and  over- 
work. If  marked,  it  causes  death,  (c)  Impairment  of  the 
function  of  the  kidneys  throws  more  work  upon  the  skin 
which  it  can  only  partially  perform;  some  of  the  work 
must  also  be  performed  by  the  lungs.  If  severe,  or  long 
continued,  death  ensues  from  autointoxication. 

599.  Describe  the  process  of  osmosis  and  give  examples 
in  the  human  economy.     {September,  1894.) 

599.  Collins  and  Rockwell's  Physiology,  page  111. 
Examples  are:  the  exchange  of  0  and  COj  in  the  pul- 
monary alveoli;  gastric  and  intestinal  absorption  (see  page 
111);  urine  in  the  glomeruli;  passage  of  blood  plasma 
through  the  capillary  walls. 

600.  Define  and  differentiate  (a)  ptomain  and  leucomain, 
(b)  chyme  and  chyle,  (c)  secretion  and  excretion.  {June, 
1902.) 

600.  (a)  Both  ptomains  and  leucomains  are  alkaloids  of 
animal   origin;   but   the   ptomains   are   the   putrefactive 


131  PHYSIOLOGY  AND  HYGIENE. 

products  of  dead  animal  tissues  or  fluids;  whereas  the 
leucomains  are  the  products  of  the  various  vital  processes 
of  the  body,  (h)  ColUns  and  Rockwell's  Physiology,  pages 
47,  100  and  111;  (c)  page  115. 

601.  Describe  the  physiological  aspect  of  atavism.  (Jan- 
uary, 1895.) 

601.  ^^  Atavism  (Lat.  atavus,  an  ancestor)  in  the  strict 
sense  is  a  return  to  the  peculiarity  of  the  ancestral  form 
of  the  species.  As  this  ancestral  form  is  generally  unknown, 
the  explanation  of  an  unusual  variation  as  due  to  atavism 
is  in  most  cases  merely  conjectural.  For  example,  the 
dark  stripes  that  appear  sometimes  upon  the  back,  shoul- 
ders, and  legs  of  horses  have  been  attributed  to  atavism 
by  Darwin,  Ewart,  and  others;  the  presence  of  these 
stripes  being  regarded  as  evidence  of  a  striped  ancestry 
when  considered  in  connection  with  the  coloring  of  other 
species  of  the  genus  Equus,  like  the  zebra,  quagga,  etc. 
Another  example  of  atavism  is  the  occasional  appearance 
of  supernumerary  mammae  and  teats  in  women  and  in 
men.  In  women  they  have  been  observed  to  produce 
milk.  These  are  regarded  as  atavistic  because  in  the 
Lemuroidea,  the  lowest  group  of  Primates,  there  are,  in 
addition  to  the  well-developed  functional  mammse  on  the 
pectoral  region,  rudimentary  teats  upon  the  abdomen  and 
groin.  They  thus  approach  the  condition  foimd  in  dogs 
and  pigs,  while  in  the  apes  and  man  there  is  normally  but 
a  single  pair  of  mammse. '^  (Reference  Handbook  of  the 
Medical  Sciences.) 

602.  Define  (a)  aphonia,  (b)  aphasia,  (c)  asphyxia.  Give 
the  cause  of  any  one  of  these  conditions.    (April,  1899.) 

602.  (a)  "Aphonia  is  speechlessness  due  to  direct  or 
reflex  disturbance  of  the  fimctions  of  the  organs  of  voice,, 
and  not  to  central  causes,  as  in  aphasia.  It  may  be  due 
to  congestion  or  inflammation  of  the  larynx,  especially 
from  overuse,  as  in  public  speakers;  to  paralysis  of  the 
laryngeal  nerves,  or  to  hysteria.''     (Duane's  Medical  Die- 


132  PHYSIOLOGY  AND  HYGIENE.      . 

tionary.)  (b)  "Aphasia  is  a  condition  in  which,  without 
mental  disease  or  lesion  of  the  peripheral  organs,  there  is 
impairment  of  the  ability  to  receive  ideas  (apraxia)  or 
communicate  them  (asymbolia) .  In  motor  aphasia  the 
patient,  although  knowing  what  he  wishes  to  say,  cannot 
express  his  ideas  by  speech  or  gestures;  due  to  lesion  of 
Broca's  centre  or  fibres  running  from  it  to  the  bulbar 
nuclei.  In  graphomotor  aphasia  the  patient  cannot  express 
his  ideas  in  writing.  In  auditory  aphasia  sounds  are  heard, 
but  their  meaning  is  not  understood.  In  visual  aphasia 
objects  are  seen,  but  not  comprehended.'^  (Duane's  Medical 
Dictionary.)  (c)  "Asphyxia  is  a  state  of  suffocation;  the 
condition  in  which  there  is  a  permanent  arrest  of  the 
respiratory  movements  and  extreme  deficiency  of  oxygen 
in  the  blood.  It  is  marked  by  extreme  cyanosis  and  a 
sense  of  suffocation,  followed  by  coma.  It  may  be  due 
to  strangulation,  drowning,  the  inhalation  of  coal  gas  or 
other  gases,  or  any  other  cause  producing  great  impair- 
ment of  respiration."     (Duane's  Medical  Dictionary.) 

603.  Describe  the  perversions  of  junction  that  may  cause 
icterus.     {September,  1899.) 

603.  Obstruction  of  the  bile-ducts  (by  parasites,  foreign 
bodies,  impaction  of  gallstones,  inspissated  bile  or  mucus, 
pressure  from  tumors  of  liver  or  pancreas,  etc.)  prevents 
the  bile  from  entering  the  duodenum.  The  bile  then  enters 
the  blood  current,  and  is  carried  throughout  the  body, 
thus  producing  the  characteristic  yellow  tint  of  skin  and 
mucous  membranes,  and  the  deep-yellow  color  of  the 
urine. 

604.  State  where  in  the  human  economy  the  following 
substances  are  found:  (a)  fibrin,  (b)  mucin,  (c)  chondrin, 
(d)  leucin,  (e)  hippuric  acid.     (June,  1899.) 

604.  (a)  In  blood  and  lymph;  (b)  in  saliva  and  synovial 
fluid;  (c)  in  bone,  cartilage;  (d)  in  pancreas,  spleen;  (e)  in 
the  urine. 


133  PHYSIOLOGY  AND  HYGIENE. 

B.  HYGIENE. 
I.  DISEASES  IN  GENERAL. 

605.  (a)  Define  and  (b)  illustrate  endemic,  epidemic, 
pandemic.    (May,  1902.) 

606.  (a)  Define  epidemic,  endemic,  (c)  Do  endemic  dis- 
eases ever  become  epidemic?    (June,  1899.) 

605  and  606.  (a)  Egbert's  Hygiene  and  Sanitation,  page 
51;  (b)  endemic,  malaria;  epidemic,  scarlet  fever;  pandemic, 
influenza;  (c)  certainly. 

607.  What  is  the  difference  between  a  contagious  and  an 
infectious  disease?    Give  an  example  of  each.    (April,  1897.) 

608.  Define  contagion,  infection.  Give  an  example  of 
each.     (January,  1898.) 

607  and  608.  A  contagious  disease  was  formerly  under- 
stood to  be  a  disease  communicated  by  direct  personal 
contact,  as  by  touch,  or  exhalations  from  the  breath  or 
skin;  example,  smallpox.  An  infectious  disease  is  a  disease 
caused  by  a  known  germ;  example,  typhoid.  The  distinc- 
tion is  now  unimportant. 

609.  Mention  five  preventable  diseases.    (January,  1892.) 

610.  Enumerate  the  preventable  epidemic  diseases.  (July, 
1893.) 

609  and  610.  Typhoid  fever,  yellow  fever,  tuberculosis, 
malaria,  cholera,  smallpox,  typhus  fever. 

611.  Mention  diseases  due  to  exposure  to  (a)  high  temper- 
ature, (b)  variable  temperature,  (c)  decreased  atmospheric 
pressure.     (June,  1902.) 

611.  (a)  Sunstroke  and  heat  exhaustion;  (b)  rheumatism 
and  catarrhal  troubles;  (c)  Egbert's  Hygiene  and  Sanita- 
tion, page  68. 

612.  What  infectious  diseases  may  be  conveyed  through  the 
medium  of  (a)  air,  (b)  water  or  food?  (c)  Give,  as  far  as 
known,  the  causative  germ  of  each  disease  mentioned.    (June, 

1902.) 


16 


134  PHYSIOLOGY  AND  HYGIENE. 

612.  (a)  Egbert's  Hygiene  and  Sanitation,  page  92; 
(b)  pages  167  to  172.  (c)  Erysipelas  is  caused  by  the 
streptococcus  erysipelatis ;  scarlet  fever  (probably),  by  the 
bacillus  of  Class  =  diplococcus  scarlatinas;  diphtheria,  by  the 
Klebs-Loeffler  bacillus;  pneumonia,  by  the  diplococcus 
pneumoniae;  tuberculosis,  by  the  bacillus  tuberculosis; 
cholera,  by  the  comma  bacillus  of  Koch,  or  spirillum  cholerse 
asiaticse;  typhoid,  by  Eberth's  bacillus ;  dysentery  (amoebic)/ 
by  the  amoeba  coli;  influenza,  by  the  bacillus  of  Pfeiffer; 
variola  (probably),  by  the  micro-organism  of  Councilman; 
cholera  infantum,  in  many  cases,  by  Shiga's  bacillus. 

613.  (a)  What  is  understood  hy  the  germ  theory  of  disease  f 
(b)  Mention  all  diseases  whose  causes  are  known  to  he  specific 
micro-organisms.     {September,  1900.) 

614.  (b)  What  diseases  are  known  to  he  caused  hy  a 
specific  micro-organism?  (c)  Describe  the  micro-organism 
peculiar  to  each  disease  mentioned,     {May,  1901.) 

615.  (a)  Discuss  micro-organisms  as  a  cause  of  disease. 
{June,  1898.) 

613  to  615.  (a)  Egbert's  Hygiene  and  Sanitation,  page 
49;  (b)  Pneumonia,  meningitis,  Malta  or  Mediterranean 
fever,  tuberculosis,  leprosy,  glanders,  anthrax,  diphtheria^ 
tetanus,  malignant  oedema,  typhoid,  cholera,  influenza^ 
bubonic  plague,  relapsing  fever,  dysentery,  actinomycosis^ 
scarlet  fever,  variola,  measles,  German  measles,  varicella, 
pertussis,  typhus  fever,  malaria,  gonorrhoea,  septicaemia, 
and  pyaemia,  (c)  For  a  description  of  these  micro-organ- 
isms, see  Abbott's  or  Archinard's  Bacteriology. 

616.  (a)  From  what  diseases  may  immunity  he  acquired 
in  the  case  of  persons  who  have  once  suffered  from  these  dis- 
eases? (b)  How  is  knowledge  of  this  fact  utilized  in  the 
prevention  of  certain  diseases?     {June,  1900.) 

616.  (a)  As  a  rule  one  attack  of  the  following  diseases 
conveys  immunity:  Whooping-cough,  rotheln,  scarlet 
fever,  typhoid,  typhus,  smallpox,  varioloid,  chickenpox, 
yellow   fever,    measles    (not   always),  and   mumps,      (b) 


135  PHYSIOLOGY  AND  HYGIENE. 

Egbert's  Hygiene  and  Sanitation,  pages  66  and  67;  and 
persons  who  are  thus  immune  are  employed  to  care  for 
those  sick  with  any  of  the  above  diseases. 

617.  (a)  How  are  pathogenic  micro-organisms  conveyed? 
(b)  What  means  can  he  taken  to  prevent  their  introduction 
into  the  system?    (June,  1899.) 

617.  (a)  By  touch,  by  the  air,  water,  and  food;  see 
Egbert's  Hygiene  and  Sanitation,  pages  92  and  167  to  172. 
(b)  Isolation  and  quarantine  of  infectious  cases;  disinfec- 
tion of  sick-rooms;  good  ventilation;  air  from  outdoors; 
boiling  of  all  food  and  beverages  that  are  from  infective 
sources;  cleanliness;  maintenance  of  bodily  health  and 
vigor,  especially  preventing  all  digestive  disturbances. 
See,  too,  Egbert's  Hygiene  and  Sanitation,  page  32;  and 
Q.  619  and  620. 

618.  What  means  should  he  employed  to  prevent  the  spread 
of  epidemics?     (Septemher,  1893.) 

619.  Enumerate  in  detail  precaution  to  he  ohserved  for 
protection  from  infection  in  the  treatment  of  an  individual 
case  of  contagious  disease.     {June,  1900.) 

620.  Name  the  principal  means  for  preventing  the  spread 
of  contagious  disease.     (Novemher,  1891.) 

618  to  620.  Egbert's  Hygiene  and  Sanitation,  pages 
339  to  342.  . 

621 .  On  what  generally  accepted  theory  are  toxins  used  for 
the  prevention  and  cure  of  disease?    (April,  1897.) 

621.  Egbert's  Hygiene  and  Sanitation,  page  58  et  seq. 

622.  Mention  some  of  the  safeguards  against  infection. 
{June,  1902.) 

622.  Egbert's  Hygiene  and  Sanitation,  pages  32,  56  et  seq, 

623.  (a)  To  what  diseases  are  negroes  comparatively 
insusceptihle?  (b)  In  middle  states  to  what  diseases  are 
negroes  more  prone  than  whites?    (June,  1896.) 

623.  (a)  Yellow  fever  and  dysentery,  (b)  Tuberculosis, 
venereal  diseases,  and  keloid. 


136  PHYSIOLOGY  AND  HYGIENE. 

6 24.  Of  what  import  is  heredity  as  a  factor  in  disease? 
Illustrate.     {April,  1898.) 

624.  Egbert's  Hygiene  and  Sanitation,  page  271. 

II.  SPECIAL  DISEASES. 

1.  Diphtheria. 

625.  (a)  How  long  does  a  diphtheria  patient  remain 
infective?  (b)  How  may  it  he  proved  that  the  infective  period 
has  ceased?    (April,  1899.) 

625.  (a)  Just  so  long  as  the  specific  bacillus  persists 
in  the  mouth,  throat,  or  nasal  passages  of  the  patient.  As 
a  rule,  diphtheritic  patients  should  not  be  allowed  to 
associate  with  healthy  people  until  at  least  fourteen  to 
eighteen  days  after  the  disappearance  of  all  membrane, 
(b)  By  the  disappearance  of  all  specific  baciUi  from  the 
mouth,  throat,  and  nasal  passages  of  the  patient. 

626.  (a)  State  the  general  results  of  observation  on  the 
hypodermic  employment  of  antitoxin  as  a  preventive  of 
diphtheria.     {January,  1896.) 

627.  (a)  Can  it  he  proved  that  the  diminished  death  rate 
from  diphtheria,  so  generally  announced,  is  due  to  the  use 
of  the  diphtheritic  antitoxin?  Give  reasons.  {January, 
1897.) 

628.  (b)  What  is  the  present  state  of  diphtheria  antitoxin? 
{September,  1898.) 

629.  (c)  Describe  the  manner  in  which  antitoxin  is  pre- 
pared.    {May,  1895.) 

626  to  629.  (a)  Egbert's  Hygiene  and  Sanitation,  pages 
65  and  66;  (b)  pages  63  to  67;  (c)  pages  63  to  65. 

630.  What  instructions  as  to  hygiene  and  sanitation  should 
be  given  in  a  case  of  diphtheria?     {May,  1898.) 

631.  Describe  the  hygienic  and  sanitary  precautions  that 
should  be  observed  in  a  case  of  diphtheria  occurring  in  a 
crowded  tenement  house?     {May,  1902.) 


137  PHYSIOLOGY  AND  HYGIENE. 

630  and  631.  Egbert's  Hygiene  and  Sanitation,  pages 
339  to  343. 

632.  What  is  the  value  of  preventive  inoculation  in  (a) 
cholera,  (b)  diphtheria?    {June,  1901.) 

632.  (a)  ^^Haffkine  made  70,000  injections  on  40,000 
people  in  India  within  a  period  of  two  years.  By  inoculat- 
ing only  a  part  of  any  given  population  where  cholera  was 
raging,  he  was  sure  of  a  control  by  which  he  could  judge 
of  the  value  of  the  work.  The  rate  of  attack  among  those 
inoculated  fell  to  about  one-twentieth,  and  the  mortality 
in  about  the  same  proportion.  Preventive  inoculation  has 
been  tried  very  extensively,  and  generally  with  at  least 
fair  results."  (Harrington's  Practical  Hygiene.)  (b)  See 
Q.  626. 

633.  What  explanation  can  he  furnished  of  the  greater 
prevalence  of  diphtheria  and  smallpox  in  cold  than  in  warm 
weather?    {April,  1895.) 

633.  In  the  cold  weather  there  are  greater  and  more 
frequent  changes  of  temperature,  and  ventilation  is  poorer; 
hence  the  vitality  of  the  body  is  lowered  and  there  is  a 
greater  liability  to  take  disease. 

2.  Tuberculosis. 

63 Jf..  Discuss  the  theory  of  hereditary  tendencies  as  applied 
to  tuberculosis.     {May,  1897.) 

634.  ''The  original  view  that  tuberculosis  in  a  majority 
of  cases  is  hereditary  and  that  children  of  tuberculous 
ancestry  were  foredoomed  to  an  early  death  from  the 
disease  is  untenable  in  light  of  the  facts  regarding  the 
Koch  bacillus.  A  fair  statement  of  the  matter  is  as  follows : 
Tuberculosis  cannot  exist  without  the  influence  of  bacilli. 
For  the  bacillus  to  be  transmitted  by  inheritance  it  must 
either  pass  to  the  embryo  through  the  spermatozoon,  the 
ovum,  or  from  the  maternal  blood  through  the  placental 


138  PHYSIOLOGY  AND  HYGIENE. 

vessels.  Tuberculosis  of  the  generative  organs  is  not  rare, 
but  the  chance  of  even  a  single  bacillus  entering  a  sperm- 
atozoon or  an  ovum  and  occupying  so  large  a  part  of  such 
cell  as  its  substance  would  necessarily  do  without  destruc- 
tion of  one  organism  or  the  other  seems  incredible.  As 
for  blood  transmission  of  the  bacillus  through  maternal 
vessels,  while  its  possibility  must  be  admitted  to  account 
for  the  few  authentic  cases  of  congenital  tuberculosis 
reported,  the  presence  of  bacilli  in  the  blood  of  the  most 
advanced  cases  of  tuberculosis  is  extremely  rare  excepting 
during  the  temporary  accident  of  the  perforation  of  a 
tuberculous  mass  into  a  bloodvessel  as  a  forerunner  of 
miliary  tuberculosis.  How,  then,  are  the  early  cases  of 
so-called  hereditary  tuberculosis  to  be  explained?  Of 
these  not  more  than  twenty  have  been  described  as  actually 
congenital  (Hahn).  The  remainder  have  all  appeared  at 
a  considerable  interval  after  birth.  The  nursing  infant, 
weakened  by  the  inheritance  of  poor  vitality,  is  kept  close 
beneath  the  bedclothing  of  a  tuberculous  mother,  and 
cannot  avoid  inhaling  bacilli  which  have  escaped  with  her 
expectoration,  transferred,  perhaps,  from  handkerchief  to 
sheet,  and  soon  dried  in  the  warmth  of  the  bed,  or  perhaps 
the  same  handkerchief  is  used  for  the  mother's  sputum 
and  the  child's  nose.  The  older  infant  is  kissed  by  a 
tuberculous  member  of  the  family,  bacilli  from  whose 
sputum  can  easily  be  found  upon  the  beard  or  face,  or  it 
is  allowed  to  crawl  about  upon  a  dusty,  germ-impregnated 
carpet.  The  disease  thus  acquired  and  developed  thus 
early  in  the  ill-conditioned  weakling  makes  rapid  strides, 
and  is  easily  attributed  in  error  to  ^heredity.'  For 
^heredity'  in  this  sense  should  be  substituted  criminal 
negligence  in  matters  hygienic."  (Thompson's  Practical 
Medicine.) 

635.  (a)  Is  consumption  communicahlef  (b)  Give  reasons 
for  your  conclusion  and  (c)  offer  hygienic  suggestions. 
(January,  1899.) 

635.  (a)  Yes;  consumption  is  communicable,     (b)  The 


139  PHYSIOLOGY  AND  HYGIENE.  - 

disease  is  caused  by  a  specific  bacillus  which  is  invariably 
present,  and  which  is  frequently  discharged  in  enormous 
numbers  in  the  sputum,  which  becomes  dried  and  pulver- 
ized and  in  this  condition  floats  in  the  air.  The  bacillus 
has  great  vitality,  living  for  weeks  in  dried  sputum.  It 
has  frequently  been  demonstrated  in  the  nasal  mucus 
of  attendants  upon  tuberculous  patients.  Finally,  there 
are  innumerable  examples  of  direct  infection  through 
association,  and  indirect  through  inhabiting  the  same 
apartments,  though  at  different  periods  of  time,  (c)  See 
Q.  636. 

636.  What  hygienic  precautions  should  he  taken  in  treating 
a  case  of  phthisis  pulmonalisf    (Mai/j  1899.) 

636.  ''The  patient's  quarters  should  be  free  from  dust 
and  admit  of  spending  many  hours  daily  in  the  open  air 
in  all  weather,  properly  sheltered,  and,  if  very  ill,  lying 
wrapped  in  a  hammock  or  reclining  chair.  His  bedroom 
should  be  well  aired  at  night,  draughts  being  avoided. 
The  room  should  be  uncarpeted  and  free  from  hangings. 
It  should  be  often  cleaned  and  periodically  disinfected. 
All  sputum  should  be  collected  in  paper  spit-cups,  which 
should  be  burned  daily.  Smoking  should  be  forbidden. 
Harm  is  done  by  any  exercise  which  results  in  fatigue^ 
and  while  fever  exists  it  should  not  be  attempted  at  all. 
Patients  should  be  taught  the  necessity  of  practising  lung 
gymnastics  and  of  breathing  only  through  the  nose,  which 
should  be  kept  clear  and  free  from  occlusion  by  secretions,. 

or  an  hypertrophied  catarrhal  mucosa The 

clothing  should  be  woollen,  but  not  too  heavy,  or  sweating: 
is  increased;  and  a  flannel  night-gown  and  loosely  knit 
leggings  should  be  worn  at  night  in  cool  weather.  The 
skin  should  be  cleansed  by  daily  sponge  baths  of  luke- 
warm alcohol  and  water."  (Thompson's  Practical  Med- 
icine.) 

637.  How  may  the  spread  of  tuberculosis  he  prevented  hy 
public  health  administration?     {June,  1899.) 


140  PHYSIOLOGY  AND  HYGIENE. 

637.  "The  preventive  measures  which  may  be  taken 
to  reduce  tuberculosis  may  be  summarized  as:  (1)  The 
compulsory  notification  of  phthisis.  (2)  The  removal  of 
those  conditions  of  domicile  and  of  occupation  which  are 
known  to  promote  the  incidence  of  the  disease,  including 
the  regulation  of  certain  dusty  trades.  (3)  The  diffusion 
of  knowledge  (by  medical  men,  leaflets,  etc.)  regarding  the 
nature  and  modes  of  spread  of  the  disease,  and  the  pre- 
cautions which  should  be  taken  in  order  to  prevent  its 
extension.  (4)  The  testing  of  sputum  and  other  suspected 
discharges,  and  of  milk,  meat,  etc.,  supposed  to  be  tuber- 
culous— reports  to  be  furnished  free  of  charge.  (5)  Local 
authorities  to  undertake,  without  charge,  the  disinfection 
of  houses  recently  occupied  by  phthisical  persons.  (6)  The 
establishment  of  sanatoria  and  isolation  accommodation 
for  the  cure  of  phthisical  patients,  and  the  isolation  of 
those  who  are  a  distinct  source  of  danger  to  fellow  lodgers 
or  workers:  (7)  The  enforcement  of  measures  against 
spitting  in  public  conveyances  and  in  places  of  public 
resort.  (8)  The  efficient  sanitary  supervision  of  dairy 
farms,  dairies,  and  milkshops.  The  periodical  veterinary 
inspection  and  testing  of  milch  cows,  and  the  slaughter  of 
tuberculous  animals.  The  prohibition  of  the  sale  of  milk 
of  cows  affected  with  tuberculosis.  (9)  The  proper  inspec- 
tion of  meat  in  public  abattoirs,  and  the  adoption  of  due 
precautions  for  the  control  of  imported  meat  and  milk.'' 
(Parkes'  Hygiene  and  Public  Health.) 

638.  (a)  What  is  the  condition  of  the  atmos'phere  at  high 
altitudes?  (b)  How  do  high  altitudes  affect  respiration  and 
hlood  circulation?  (c)  How  is  the  progress  of  pulmonary 
phthisis  influenced  by  residence  in  a  dry  atmosphere  of  high 
altitude?     {September,  1901.) 

639.  (d)  Mention  six  desirable  factors  in  the  location  of 
a  resort  for  consumptives.     {May,  1893.) 

640.  (d)  What  climate  is  best  adapted  to  sufferers  from 
phthisis  pulmonalis?    (c)  Why?    {November,  1894.) 


141  PHYSIOLOGY  AND  HYGIENE. 

638  to  640.  (a)  The  atmospheric  pressure  is  diminished; 
the  air  is  rarefied,  has  greater  movement,  is  more  free  from 
foreign  matter,  and  contains  more  ozone;  there  is  more 
sunUght  and  less  humidity,  (b)  ''The  breathing  becomes 
more  rapid,  so  that  while  less  oxygen  is  taken  in  at  each 
breath  it  is  received  into  the  blood  more  frequently;  and 
with  this  more  rapid  respiration  there  is  increased  heart 
action,  the  heart  pumping  more  blood  through  the  lungs 
in  a  given  space  of  time.  This  increased  rapidity  of  heart 
beat  and  respiration  is,  however,  only  temporary,  and 
gradually  disappears.  The  amoimt  of  air  taken  in  at  each 
breath  increases  in  volume  as  the  chest  expands,  and  the 
air  cells,  many  of  which,  at  lower  altitudes,  are  often 
unused,  become  enlarged.  The  heart's  cavities,  having 
been  stretched,  are  also  hypertrophied,  so  that  more  blood 
is  propelled  at  each  stroke.  Thus  the  blood's  capacity  for 
absorbing  oxygen,  the  lung's  capacity  for  taking  air,  and 
the  heart's  capacity  for  pumping  blood  are  increased;  the 
rapidity  of  respiration  and  pulse  diminishes,  but  this  rate 
becomes  normal  again  as  soon  as  this  process  of  compensa- 
tion has  effected  a  balance."  {Reference  Handbook  of  the 
Medical  Sciences.)  (c)  There  is  less  danger  of  reinfection 
and  the  conditions  mentioned  in  (d)  form  an  ideal  climate 
for  strengthening  the  body  resistance,  which  is  the  rationale 
of  treatment  in  this  disease.  The  disease  is  therefore  fre- 
quently arrested,  sometimes  cured,  or  its  duration  pro- 
longed. See  also  (b).  (d)  Pure  air  free  from  dust,  equable 
temperature,  protection  from  high  winds,  dry  soil,  dry  air, 
high  altitude,  and  plenty  of  sunlight. 


3.  Typhoid  Fever. 

641.  What  hygienic  and  sanitary  measures  should  the 
attending  "physician  take  in  a  case  of  typhoid  fever?  (June, 
1898.) 

642.  What  hygienic  measures  should  he  observed  in  the 
sick-chamber  in  a  case  of  typhoid  fever?    (May,  1896.) 


142  PHYSIOLOGY  AND  HYGIENE. 

643.  Give  the  hygiene  of  the  sick-room  in  typhoid  fever, 
{Septemher,  1896.) 

6Jf.Jj..  What  hygienic  precautions  would  you  take  to  prevent 
the  spread  of  typhoid  fever?    {May,  1894.) 

641  to  644.  Egbert's  Hygiene  and  Sanitation,  pages  339 
to  343,  328  to  330,  and  415. 

64^.  How  would  you  disinfect  and  dispose  of  the  stools  in 
typhoid  fever?     {July,  1893.) 

646.  How  would  you  dispose  of  the  dejecta  of  typhoid  fever 
in  city  and  in  country?    {March,  1892.) 

645  and  646.  See  Q.  825. 

647.  What  procedure  should  he  employed  to  locate  and 
remove  the  cause  of  an  outbreak  of  typhoid  fever  in  camp? 
{January,  1900.) 

647.  Egbert's  Hygiene  and  Sanitation,  pages  407  to  409^ 
411,  and  415. 

4.  Scarlet  Fever. 

648.  Within  what  limit  of  time  may  scarlet  fever  he  received 
by  contagion?     {September,  1892.) 

648.  Seven  or  eight  weeks,  or  until  the  last  evidences 
of  desquamation  have  disappeared. 

649.  What  steps  should  be  used  to  prevent  the  spread  of 
scarlet  fever?    {September,  18 94-) 

649.  See  A.  641  to  644;  also  the  patient  should  receive 
frequent  baths  during  convalescence.  Inunction  with  a 
mild  antiseptic  ointment  is  also  much  practised.  Clothing 
and  bed-linen  should  be  thoroughly  boiled  as  a  preliminary 
to  washing.  The  mouth  and  throat  should  also  be  thor- 
oughly cleansed  at  frequent  intervals. 

6.  Miscellaneous. 

660.  State  the  period  of  incubation  in  (a)  vaccinia,  (b) 
parotitis,  (c)  pertussis,  (d)  varicella,  (e)  rotheln.  {April, 
1899.) 


143  PHYSIOLOGY  AND  HYGIENE. 

650.  (a)  About  four  or  five  days;  (b)  about  two  weeks; 
(c)  from  four  to  fourteen  days;  (d)  from  ten  to  sixteen  days; 
(e)  from  ten  to  fourteen  days.  The  above  figures  are 
averages.  And  see  Egbert's  Hygiene  and  Sanitation,  pages 
313  and  314. 

651.  Contrast  the  incubative  stages  of  (a)  measles  and  (b) 
scarlet  fever.     {November,  1892.) 

652.  Contrast  the  incubative  stages  of  (c)  variola  and  (a) 
measles.     {September,  1896.) 

651  and  652.  (a)  From  ten  to  fourteen  days;  (b)  from 
a  few  hours  to  six  days;  (c)  from  ten  to  fourteen  days; 
These  figures  are  approximate  only.  See  also  Egbert's 
Hygiene  and  Sanitation,  pages  313  and  314. 

653.  Give  the  incubation  period  and  the  prodromata  of 
^(a)  scarlatina,  (b)  measles,  (c)  pertussis.    {May,  1902.) 

653.  For  incubation  periods  see  Q.  650  to  652.  The 
prodromata  are:  (a)  in  scarlatina,  vomiting  or  convulsions, 
sometimes  a  chill,  often  it  begins  suddenly;  (b)  measles, 
(Catarrh,  sneezing,  cough,  discharge  from  nose ;  (c)  pertussis, 
coryza,  discharge  from  nose,  cough,  fever,  sneezing. 

65J/..  How  may  public  health  administration  be  potent  in 
preventing  the  spread  of  (a)  smallpox,  (b)  diphtheria,  and 
(c)  scarlet  fever?    {September,  1902.) 

655.  What  sanitary  steps  should  be  taken  for  the  protection 
of  public  health  in  the  treatment  and  management  of  (c) 
scarlet  fever,  (a)  smallpox,  and  (b)  diphtheria?    {May,  1899.) 

654  and  655.  In  general  by  abating  nuisances;  by 
enforced  isolation  as  long  as  the  case  is  infective  or  removal 
to  special  hospital,  where  this  is  impossible;  by  detention 
in  quarantine  of  individuals  who  may  reasonably  be 
expected  to  contract  the  disease,  such  detention  to  last 
until  the  lapse  of  the  incubative  period  from  the  last 
occasion  of  exposure  shows  them  to  be  immune;  by  pro- 
viding for  thorough  disinfection  by  the  most  efficient 
methods  of  premises  and  fomites,  under  competent  super- 


144    ,  PHYSIOLOGY  AND  HYGIENE, 

vision.  Specifically,  in  addition:  (a)  by  compulsory  or 
voluntary  gratuitous  vaccination  of  all  exposed  persons 
with  vaccine  of  reliable  properties,  (b)  By  providing 
gratuitous  administration  of  diphtheria  antitoxin  to  those 
imable  to  pay,  both  for  curative  and  immunizing  purposes, 
(c)  See  general  remarks  above. 


6.  Scurvy. 

656.  What  measures  (including  diet  and  medication) 
should  he  used  on  ship-hoard  or  in  camp  to  eradicate  scurvy 
(scorhutus)?     (April,  1896.) 

656.  '^Abundant  fresh  air  and  sunlight,  and  a  diet  of 
fresh  vegetables,  especially  potatoes,  spinach,  and  fruits, 
with  meat,  eggs,  fish,  etc.  If  the  stomach  is  irritable, 
fresh  milk,  eggs,  and  lime,  orange  or  lemon  juice  may 

almost  always  be  tolerated A  mouth  wash  of 

saturated  boric  acid,  alternating  with  a  2  per  cent,  solution 
of  potassium  permanganate,  should  be  used  every  hour 
or  two  until  the  gums  are  healed."  (Thompson's  Practical 
Medicine.) 

7.  Heat  Stroke. 

657.  How  should  a  patient  who  has  heen  rendered  un- 
conscious hy  heat  he  treated?     (September,  1896.) 

657.  (1)  Thermic  fever  should  be  treated  by  cold  baths; 
for  the  rest,  symptomatic  treatment  is  employed;  chloral, 
chloroform,  or  bromides  for  convulsions;  strychnine  and 
digitalis  for  heart-failure,  etc.  (2)  Heat  exhaustion  requires 
absolute  rest,  dry  heat,  and  frictions ;  stimulants  in  moderate 
quantities  and  easily  assimilated  food  are  indicated. 

8.  Yellow  Fever 

658.  Mention  methods  to  he  employed  for  preventing 
epidemics  of  yellow  fever  in  the  tropics.    (January,  1900.) 


145  PHYSIOLOGY  AND  HYGIENE. 

658.  Isolation  of  cases,  with  screening  by  mosquito- 
netting;  draining  of  all  swampy  places  and  filling  in  of 
all  puddles  of  stagnant  water;  destruction  of  mosquitoes 
as  far  as  practicable  within  the  infected  area. 

9.  Cholera. 

659.  What  means  can  best  he  employed  to  exclude  and 
prevent  cholera?     (July,  1893.) 

659.  Quarantine  and  disinfection  of  all  ships  coming 
from  cholera  ports.  Complete  isolation  of  patients,  with 
thorough  disinfection  of  all  discharges — vomitus,  dejecta, 
urine — and  sterilization  of  all  bed-clothes  and  wearing 
apparel.  In  case  of  death  the  corpse  should  be  cremated 
or  buried  in  quicklime  or  in  hermetically  sealed  casket 
after  being  immersed  in  antiseptic  solution. 

10.  Bubonic  Plague. 

660.  (a)  What  is  the  bubonic  plague f  (b)  What  steps 
can  be  taken  to  limit  or  to  extinguish  such  a  scourge?  (Janu- 
ary, 1899.) 

660.  (a)  ^'Bubonic  plague  is  an  infectious  febrile  disease, 
characterized  by  a  tendency  to  buboes  or  carbuncles,  in 
addition  to  the  phenomena  of  the  typhoid  state."  (Tyson.) 
(b)  ''Prophylaxis  involves  the  most  rigid  sanitary  cordon, 
compelling  thirty  days  of  isolation  after  recovery  and  ten 
days  after  exposure  to  infection ;  vigorous  sanitary  measures 
should  be  maintained,  such  as' cleansing  streets  and  houses 
with  lime  and  5  per  cent,  carbolic  acid,  removal  of  all 
pest  holes,  cremation  of  all  excreta  and  cadavers,  dis- 
infection of  patients'  bedding  and  clothing  by  superheated 
steam  under  pressure  or  prolonged  boiling,  formaldehyde 
fumigation  of  the  sick-room,  etc.  All  vermin,  and  especially 
rats,  should  be  exterminated.  Prophylactic  inoculations 
are  practised  by  Haffkine  by  sterilized  attenuated  bouillon 


146  PHYSIOLOGY  AND  HYGIENE. 

cultures  of  the  bacillus  bubonicse The  immunity, 

T^hen  conferred  does  not  appear  to  last  longer  than  a  few 
weeks/'     (Thompson's  Practical  Medicine.) 

11.  Influenza. 

661.  Mention  some  of  the  remote  consequences  of  epidemic 
influenza  on  public  health.     (November,  1892.) 

661.  ''The  disease  is  much  more  fatal  in  some  epidemics 
than  in  others,  and  many  deaths  occur  among  those  having 
long-standing  chronic  diseases  or  debility  when  attacked 
by  influenza,  so  that  the  general  mortality  always  rises 

during  an  epidemic Alcoholic  subjects  and 

old  people  are  most  liable  to  succumb  to  influenza  pneu- 
monia."    (Thompson's  Practical  Medicine). 

12.  Pregnancy. 

662.  What  hygienic  precautions  should  be  observed  by  a 
pregnant  woman?     {January,  1893.) 

663.  What  special  hygienic  care  do  parturient  patients 
require?     (January,  1892.) 

662  and  663.  She  requires  pure  air,  mild  out-door 
exercise  when  possible,  clothing  free  from  constrictions  of 
all  kinds;  cold  and  draughts  must  be  avoided;  warm  baths 
should  be  taken  at  least  three  times  a  week;  during  the 
later  weeks  of  pregnancy  the  nipples  should  be  kept 
scrupulously  clean,  free  from  pressure,  and  softened  by 
application  of  borated  vaselin  or  cocoa-butter;  sleep  and 
ample  rest  are  requisite ;  coitus  should  be  avoided ;  crowded 
apartments,  theatres,  churches,  etc.,  should  be  shunned; 
constipation  should  be  corrected,  and  the  urine  should  be 
examined  every  two  weeks.  (From  King's  Manual  of 
Obstetrics.) 


147  PHYSIOLOGY  AND  HYGIENE 

III.  FOOD  AND  BEVERAGES. 

1.  Tea. 

664.  (a)  Describe  the  method  of  making  a  cup  of  (green) 
tea,  as  a  beverage  or  as  a  prescription.    (November,  1894.) 

665.  (b)  To  what  is  the  indigestion  from  excessive  tea- 
drinking  attributable?  (a)  State  a  formula  for  the  prepara- 
tion of  good  tea.    (January,  1896.) 

666.  (c)  Mention  the  disorders  to  which  "tea-tasters''  are 
subject.     (January,  1894.) 

664  to  666.  (a)  and  (b)  "Tea  should  be  used  only  in  the 
form  of  an  infusion,  made  by  pouring  boiling  water  upon  the 
requisite  amount  of  leaves,  and  allowing  it  to  stand  a 
short  while  to  "draw."  It  is  used  not  uncommonly  in  the 
form  of  a  decoction;  that  is,  by  boiling.  This  process  is 
objectionable  in  two  ways:  first,  the  delicate  aroma  is  lost 
by  the  expulsion  of  the  very  volatile  essential  oil;  and 
second,  the  leaves  are  made  to  yield  all  their  tannin  and 
other  extractives,  which  tend  to  bring  about,  sooner  or 
later,  derangement  of  the  digestive  function  and  a  catarrhal 
condition  of  the  stomach.  The  finest  and  most  delicate 
portion  of  an  infusion  is  that  which  is  poured  off  within 
three  or  four  minutes,  for  in  this  will  be  found  a  maximum 
of  flavor  with  a  minimum  of  bitterness  and  astringency. 
The  excellence  of  an  infusion  is  influenced  considerably 
by  the  character  of  the  water,  which,  if  very  hard,  is  slow 
in  extracting  the  desirable  soluble  constituents,  while,  if 
very  soft,  it  extracts  not  only  these,  but  far  too  rapidly 
the  less  desirable  principles."  (Harrington's  Practical 
Hygiene.)  (c)  Cardiac  neuroses  ("tea-drinkers'  heart")^ 
gastric  neuroses,  gastric  catarrh. 

2.  Coffee. 

667.  Mention  some  of  the  adulterations  of  ground  coffee  for 
sale  in  the  shops.     (May,  1893.) 


148  PHYSIOLOGY  AND  HYGIENE. 

667.  Harrington,  in  his  Practical  Hygiene,  mentions  the 
following  substances  as  adulterants  of  coffee:  " Chicory , 
dandelion,  and  other  roots;  roasted  cereals  and  legumes, 
sawdust,  date  stones,  red  slate,  acorns,  and  other  cheap 
articles/' 

3.  Butter. 

668.  What  are  the  properties  of  oleomargarin  butter  com- 
pared with  butter  made  in  the  usual  way?    (September,  1892.) 

669.  How  is  oleomargarin  distinguished  from  butter? 
(September,  1894.) 

668  and  669.  Egbert's  Hygiene  and  Sanitation,  pages 
456,  457  and  244. 

4.  Milk. 

670.  (a)  What  constitutes  a  thorough  meat  inspection? 
(b)  How  should  an  inspection  of  milk  be  conducted?  (May, 
1897.) 

670.  (a)  ''In  this  country,  under  the  inspection  law  of 
March  3,  1891,  ....  the  animals  are  inspected 
before  being  slaughtered,  and  their  carcasses  are  examined 
microscopically   by    officials    of    the    Bureau   of   Animal 

Industry   before   being   packed The   United 

States  inspectors  are  instructed  to  condemn  all  female 
animals  in  an  advanced  stage  of  gestation,  and  to  prevent 

their  slaughter  for  food Females  in  which 

parturition  has  recently  occurred  are  likewise  condemned 

as  unfit  for  food The  cattle  diseases  most 

prominent  as  causes  of  condemnation  are  tuberculosis, 
actinomycosis,  and  anaemia;  next  in  order  are  septicaemia, 
pneumonia,  peritonitis,  pyaemia,  icterus,  abscesses,  and 
Texas  fever.  In  swine  the  most  common  diseases  are  hog 
cholera,  swine  plague,  tuberculosis,  icterus,  pyaemia, 
abscesses,  pneumonia,  inflammations  of  the  abdominal 
cavity,  septicaemia  and  tumors.  The  most  common  causes 
of  condemnation  of  sheep  are  anaemia  and  emaciation. 


149  PHYSIOLOGY  AND  HYGIENE. 

bruises  and  injuries,  tuberculosis,  abscesses,  pneumonia, 

uraemia,  septicaemia,  icterus,  and  pyaemia In 

inspecting  meats,  special  attention  should  be  paid  to  the 
connective  tissue  and  glandular  organs.  The  odor  of  a 
carcass  should  be  sweet,  and  the  meat  should  communicate 
no  unpleasant  smell  to  a  wooden  skewer  thrust  into  it 
and  withdrawn.  The  muscle  should  be  firm  and  elastic, 
but  not  tough.  Any  variation  from  the  natural  color 
should  be  regarded  with  suspicion.''  (Harrington's Pmc^icai^ 
Hygiene.)  And  see  Egbert's  Hygiene  and  Sanitation, 
pages  247  and  248;  (b)  page  450. 

671.  Under  what  conditions  is  tyrotoxicon  found  in  milk, 
cheese,  meat,  and  other  articles?    (June,  1894.) 

671.  Egbert's  Hygiene  and  Sanitation,  page  240. 

672.  (a)  What  diseases  arise  from  the  ingestion  of  unclean 
and  contaminated  milk?  (b)  What  safeguards  should  he 
adopted  to  mdlify  the  possibility  of  disease  from  such  a 
source?    (January,  1902.) 

673.  (a)  What  disease-carrying  bacilli  may  he  conveyed 
to  the  system  by  the  ingestion  of  milk?  (c)  What  are  the 
microscopic  characteristics  of  such  bacilli?    (June,  1900.) 

674'  (a)  What  infectious  diseases  may  be  carried  by  milk? 
(d)  By  what  means  are  the  germs  of  these  diseases  introduced 
into  milkf     (January,  1901.) 

675.  (a)  Name  four  diseases  that  are  communicable  to 
man  through  coios'  milk?     (January,  1896.) 

672  to  675.  (a)  Egbert's  Hygiene  and  Sanitation,  page 
241;  (b)  page  242;  (c)  see  Q.  614  (c);  (d)  Egbert's  Hygiene 
and  Sanitation,  pages  240  to  243 ;  and  see  A.  676  and  677. 

676.  How  may  milk  be  the  means  of  transmitting  the  germs 
of  typhoid  fever?    (April,  1899.) 

677.  State  in  what  way  the  germs  of  typhoid  fever  may  he 
conveyed  in  milk  drawn  from  healthy  cows  and  used  for 
food?     (June,  1893.) 

676  and  677.  By  the  use  of  water  containing  Eberth's 


18 


150  PHYSIOLOGY  AND  HYGIENE. 

bacillus  (of  typhoid)  for  the  purposes  of  either  diluting  the 
milk  or  washing  the  milk  cans  and  bottles. 

678.  Mention  at  least  three  adulterations  of  milk.    (April,. 

1894.) 

679.  What  are  the  principal  adulterations  of  milk?  {April, 
1895.) 

678  and  679.  Milk  is  adulterated  (1)  by  skimming,  (2) 
by  the  addition  of  water,  (3)  by  the  addition  of  coloring 
matters  such  as  annatto  or  caramel,  (4)  by  the  addition  of 
preservatives,  as  boric  acid,  formaldehyde,  salicylic  acid,  or 
salicylates,  and  (5)  by  the  addition  of  arrowroot,  flour, 
sugar,  etc. 

680.  Describe  what  should  he  done  to  insure  milk  from 
impurities  from  the  moment  it  has  been  received  from  the  cow 
to  the  time  of  its  delivery  to  families.    {January,  1894.) 

680.  All  receptacles  should  be  scalded  with  boiling  water. 
Milkers  should  wipe  the  teats,  and  also  wash  their  own 
hands  before  milking.  Stables  should  be  kept  scrupulously 
clean  and  freely  ventilated.  All  accidental  contamination 
should  cause  the  rejection  of  that  particular  pail  of  milk. 
The  milk  should  at  once  be  strained  and  cooled  to  about 
40°  F.  and  kept  at  not  above  that  temperature  until 
delivery  to  the  consumer.  Delivery  should  be  as  prompt 
as  possible. 

5.  Meat. 

681.  What  conditions  and  diseases  in  animals  render  their 
fesh  unfit  for  food?    {September,  1895.) 

681.  Egjbert's  Hygiene  and  Sanitation,  pages  247  and 
248;  and  see  A.  670  (a). 

IV.  ALCOHOL  AND  TOBACCO. 

1.  Alcohol. 

682.  Name  the  principal  adulterations  of  wine.  {Sep- 
tember, 1893.) 


151  PHYSIOLOGY  AND  HYGIENE. 

682.  Water,  alcohol,  alum,  glycerin,  logwood,  nux 
vomica,  cream  of  tartar,  prunes,  dates,  raisins,  bitter 
almonds,  orange  peel,  various  berries,  coal-tar  products, 
salicylic  acid,  formaldehyde,  sugar,  gypsum. 

683.  What  are  the  diseases  the  predisposition  to  which  is 
greatly  increased  by  the  habitual  use  of  alcoholics?  (April, 
'l896.) 

OSJf..  To  what  diseases  does  the  excessive  use  of  alcoholics 
predispose,  and  why?    {September,  1895.) 

685.  Describe  the  disturbances  of  function  produced  by  the 
excessive  imbibition  of  alcohol.     (JSfovember,  1893.) 

683  to  685.  It  increases  the  predisposition  to  all  the 
infectious  diseases  and  stands  in  more  or  less  direct  causal 
relation  to  the  following:  Acute  and  chronic  catarrhal 
gastritis,  catarrhal  duodenitis,  fatty  liver,  hepatic  cirrhosis, 
cardiac  hypertrophy  and  dilatation,  fatty  infiltration  of  the 
heart,  chronic  myocarditis,  arteriosclerosis,  aneurysm, 
nephritis  (acute,  chronic,  parenchymatous,  and  interstitial), 
gout,  neuritis,  pachymeningitis,  apoplexy,  epilepsy,  delir- 
ium tremens,  and  the  chronic  psychoses. 

686.  What  effect  have  strong  alcoholic  stimulants  on  the 
gastric  juice?     {September,  1892.) 

686.  Taken  occasionally,  and  in  small  quantities,  they 
increase  its  secretion  and  facilitate  digestion;  imbibed  in 
large  quantity,  they  cause  acute  catarrhal  gastritis  with 
impairment  or  suspension  of  secretion;  if  frequently  re- 
peated, the  constant  stimulation  may  induce  a  chronic 
catarrhal  gastritis,  with  diminution  or  cessation  of  secretion. 

2.  Tobacco. 

687.  Mention  some  of  the  results  of  tobacco  smoking  in 
growing  school-boys,  in  respect  to  (a)  the  circulation,  (b)  air 
passages,  (c)  vision,  and  (d)  mental  application.  {March, 
1893.) 


152  PHYSIOLOGY  AND  HYGIENE. 

688.  What  are  the  possible  results  of  the  use  of  tobacco  hy 
growing  hoys  in  regard  to  (a)  circulation,  (c)  vision,  (b)  air- 
passages  9    (September,  1902.) 

687  and  688.  (a)  The  circulation  is  slowed,  arterial 
tension  lowered  and  afterward  raised,  the  heart  is  depressed, 
and  some  times  palpitation  is  produced,  (b)  The  air  pass- 
ages are  irritated  and  slightly  inflamed,  (c)  Vision  may  be 
impaired  by  a  mild  conjunctivitis  or  amblyopia,  (d) 
Mental  application  is  lessened.  If  used  in  excess  the 
results  may  be  fatal. 

689.  Mention  some  of  the  chief  diseases,  local  and  consti- 
tutional, produced  in  tobacco  smokers  and  chewers.  (Sep- 
tember, 1893.) 

690.  What  evil  consequences  frequently  result  from  the 
excessive  use  of  tobacco?    {September,  1896.) 

689  and  690.  ^^  The  continued  use  of  tobacco,  by  smoking 
or  chewing  it  to  excess,  produces  granular  inflammation 
of  the  fauces  and  pharynx,  atrophy  of  the  retina,  dyspepsia, 
lowered  sexual  power,  sudden  faints,  nervous  depression, 
cardiac  irritability,  and  occasionally  angina  pectoris.  Used 
by  the  young  it  hinders  the  development  of  the  higher 
nerve  centres  and  impairs  the  mitrition  of  the  body  by 
interfering  with  the  processes  of  digestion  and  assimilation. 
It  has  been  credited  with  causing  cancer  of  the  lips  and 
tongue,  blunting  of  the  moral  sense,  mental  aberration  and 
even  insanity.  The  so-called  'tobacco  heart'  includes  many 
forms  of  nervous,  painful,  or  oppressed  cardiac  action, 
depending  on  the  age  of  the  subject,  the  quantity  consumed, 
and  other  circumstances."    (Potter's  Materia  Medica,  etc.) 

V.  WATER  AND  ICE. 

1.  Water. 

691 .  What  is  the  temperature  (a)  of  tepid  water;  (b)  of  hot 
water;  (c)  of  boiling  water?  (April,  1894.) 

691.  (a)  75°  to  85°  F.;  (b)  100°  to  110°  F.;  (c)  212°  F. 


153  PHYSIOLOGY  AND  HYGIENE. 

692.  (a)  What  should  he  the  characteristics  of  'potable 
water?  (b)  What  amount  of  solid  matter  is  permissible  in 
potable  water?     {June,  1899.) 

692.  (a)  Egbert's  Hygiene  and  Sanitation,  pages  164 
and  166,  and  213;  (b)  page  213. 

693.  Name  the  physical  properties  of  pure  water.  {No- 
vember, 1891.) 

694-  What  physical  characteristics  should  be  observed  in 
the  examination  of  water  for  sanitary  purposes?  (May, 
1901.) 

693  and  694.  Egbert's  Hygiene  and  Sanitation,  pages 
213  and  441. 

695.  What  constitutes  (a)  hard  water,  (b)  soft  water? 
{September,  1898.) 

695.  (a)  Egbert's  Hygiene  and  Sanitation,  page  151; 
(b)  freedom  from  the  salts  of  calcium  or  magnesium  in 
solution. 

696.  (a)  What  is  the  best  water  for  drinking  purposes? 
(b)  Describe  an  emergency  water-filter.     {April,  1899.) 

697.  (b)  How  can  a  water  filter  he  extemporized?  {March, 
1892.) 

696  and  697.  (a)  Egbert's  Hygiene  and  Sanitation,  page 
164;  (b)  pages  192  to  205. 

698.  (a)  Mention  the  natural  and  the  artificial  sources  of 
water  supply,  (b)  What  is  the  possible  action  of  water  on 
lead  pipe?    {June,  1901.) 

699.  (c)  Mention  at  least  three  prominent  symptoms  of 
poisoning  by  lead  received  through  drinking  water  or  any 
other  source.     {September,  1892.) 

700.  (a)  Give  the  principal  sources  of  the  water  supply  of 
cities,  (d)  How  may  these  sources  become  contaminated? 
{June,  1900.) 

701.  (a)  What  are  the  reliable  sources  of  a  pure  water 
supply?    {April,  1898.) 


154  PHYSIOLOGY  AND  HYGIENE. 

702.  (e)  Mention  some  of  the  objections  to  curbed  or 
driven  wells  in  streets  or  houses,  with  respect  to  the  purity 
of  the  water  coming  from  these  wells.    {May,  1895.) 

698  to  702.  (a)  Egbert's  Hygiene  and  Sanitation,  page 
148  et  seq.;  (b)  page  168;  the  oxide  of  lead  which  is  formed 
upon  the  surface  of  the  lead  pipe  is  constantly  dissolved 
and  carried  away  in  the  water,  (c)  Pain  in  the  region  of 
the  umbilicus,  blue  line  on  the  gums  (due  to  the  formation 
of  lead  sulphide),  wrist-drop,  anaemia  or  cachexia,  with  a 
notable  decrease  in  the  number  of  red  blood  corpuscles. 

(d)  Egbert's  Hygiene  and  Sanitation,  pages  148  to  166; 

(e)  pages  162  to  164. 

703.  Describe  a  method  of  purifying  water  for  (1)  public 
supply;  (2)  domestic  use.     {May,  1902.) 

704.  What  means  may  be  employed  to  purify  polluted 
water?     {June,  1892.) 

705.  Describe  a  process  for  purifying  water.    {May,  1899.) 

706.  What  steps  should  he  taken  to  render  polluted  water 
harmless?     {January,  1896.) 

707.  What  are  some  of  the  common  impurities  of  drinking 
water?  How  may  such  impurities  be  rem,oved?  {January^ 
1898.) 

703  to  707.  Egbert's  Hygiene  and  Sanitation,  pages  152, 
155,  172  and  206  to  213. 

708.  (a)  Name  three  tests  for  detecting  impurities  in 
water.     {November,  1891.) 

709.  (b)  Now  should  a  specimen  of  water  be  examined  to 
determine  the  presence  of  gases  indicative  of  fermentation  or 
putrefaction?    {September,  1901.) 

710.  (c)  //  a  chemical  analysis  of  water  revealed  the 
presence  of  nitrates  and  nitrites,  would  this  condemn  it  for 
drinking  purposes?    If  so,  why?    {May,  1896.) 

708  to  710.  (a)  Egbert's  Hygiene  and  Sanitation,  pages 
205  to  213,  and  441  to  449;  (b)  pages  444,  443  and  448; 
(c)  pages  211  and  212. 


155  PHYSIOLOGY  AND  HYGIENE. 

711.  Mention  some  objections  to  the  use  of  river  water  for 
drinking  purposes.     (April,  1897.) 

711.  Egbert's  Hygiene  and  Sanitation,  page  152. 

712.  (a)  What  infectious  diseases  may  he  due  to  impure 
drinking  water?     (May,  1897.) 

713.  (b)  What  diseases  may  arise  from  drinking  impure 
water?     (June,  1895.) 

712  and  713.  (a)  Egbert's  Hygiene  and  Sanitation,  page 
168;  (b)  pages  167  to  172. 

714'  What  is  accomplished  by  the  aeration  of  water  which 
is  distributed  in  a  city  supply?    (April,  1895.) 

714.  Little  beyond  oxidation  of  offensively  smelling 
organic  material.  Bacteria  in  general  are  not  much  affected 
unless  direct  sunlight  is  coincidently  employed. 

715.  What  impurities  may  he  found  in  rain-water  stored 
in  cisterns?     (April,  1894.) 

716.  Mention  some  of  the  objections  to  storage  cisterns 
under  ground.  What  are  the  objections  to  rain  water  as  a 
drink?     (May,  1898.) 

715  and  716.  Egbert's  Hygiene  and  Sanitation,  pages 
149  to  151. 

2.  Ice. 

717.  (a)  Give  the  best  sources  of  ice  supply,  (b)  What 
precautions  should  he  taken  in  making  artificial  ice?  (Sep- 
tember, 1896.) 

111.  (a)  Artificial  ice  is  the  best;  next  to  this  is  natural 
ice  from  a  pond  or  lake  free  from  all  contamination,  (b) 
It  should  be  made  from  boiled  or  distilled  water. 

718.  State  the  properties  or  qualities  of  artificial  ice  as 
contrasted  with  natural  ice.     (September,  1894.) 

719.  Mention  some  of  the  advantages  of  carefully  prepared 
artificial  ice,  as  compared  with  natural  ice.    (June,  1896.) 

718  and  719.  If  properly  manufactured,  artificial  ice  is 


156  PHYSIOLOGY  AND  HYGIENE, 

generally  cleaner  and  safer  to  use  on  account  of  impurities 
generally  to  be  found  in  the  natural  commercial  product. 

7£0.  What  impurities  of  ice  are  likely  to  cause  disease? 
(May,  1894.) 

721.  What  are  some  of  the  dangers  involved  in  the  domestic 
use  of  icef     (November,  1892.) 

720  and  721.  See  under  ''Water/'  Egbert's  Hygiene  and 
Sanitation,  pages  167  et  seq.,  and  205. 

VI.  AIR  AND  VENTILATION. 

722.  Describe  the  effect  of  a  hot  and  moist  atmosphere  on 
the  human  system  and  state  the  class  of  diseases  this  atmos- 
phere is  likely  to  induce.     (May,  1900.) 

722.  It  depresses  all  vital  functions,  renders  the  circula- 
tion sluggish,  soothes  the  mucous  membranes,  markedly 
increases  the  amount  of  sensible  perspiration  because  of 
diminished  evaporation,  and  causes  general  languor  and 
lassitude.  It  predisposes  to  all  diarrhceal  troubles,  and  may 
directly  cause  thermic  fever  or  heat  exhaustion. 

723.  (a)  Define  humidity  of  the  atmosphere,  (b)  Why 
should  a  humid  atmosphere  cause  rheumatic  and  gouty  persons 
increased  sensitiveness f     (May,  1897.) 

723.  (a)  Humidity  is  the  amount  of  watery  vapor  con- 
tained in  the  atmosphere.  Expressed  in  degrees,  it  denotes 
the  approach  to  the  saturation  point  at  the  existent 
temperature.  See  Egbert's  Hygiene  and  Sanitation,  pages 
71  and  72.  (b)  Because  of  its  general  depressant  effect  it 
diminishes  the  circulatory  action  and  oxidation  processes, 
which,  in  these  subjects,  are  already  below  normal,  and 
therefore  causes  large  production  of  toxic  substances.     ^;  -. 

724.  What  are  the  effects  of  humidity  on  the  systemf 
{January,  1895.) 

724.  See  Q.  722  and  723. 

725.  (a)  What  is  the  nature  of  air  in  soils  f  (b)  In  what 
manner  are  such  diseases  as  typhoid  fever,  cholera,  dysentery 


157  PHYSIOLOGY  AND  HYGIENE. 

and  diarrhoea  produced  by  telluric  influence?  (c)  What 
means  of  correction  should  he  employed?  (January,  1897.) 
726.  (a)  How  is  soil  air  polluted?  {June,  1897.) 
725  and  726.  (a)  Egbert's  Hygiene  and  Sanitation,  pages 
87  to  89;  (b)  page  98.  '^It  is  believed  quite  generally  that 
typhoid  is  connected  in  some  way  with  soil  conditions  as 
well  as  with  drinking-water.  Indeed,  there  are  some 
authorities  who  regard  the  soil  as  of  infinitely  greater 
importance  in  the  causation  of  epidemics  of  this  disease 
and  of  cholera  than  drinking-water,  which  to  their  minds 
has  absolutely  no  influence  one  way  or  another.  The 
Pettenkof  er  theory  of  the  cause  of  these  outbreaks  attributes 
it  to  the  soil,  from  which  the  exciting  cause  is  distributed 
by  the  ground  air,  which  is  in  constant  movement.  Ac- 
cording to  the  distinguished  originator  of  the  soil  theory, 
the  unknown  poison  is  introduced  into  the  soil,  where 
under  proper  conditions  of  organic  filth,  and  other  influ- 
ences, a  species  of  fermentation  occurs,  the  end  product 
of  which  is  the  exciting  cause,  which  is  then  capable  of 
inducing  the  disease  in  those  by  whom  it  is  inhaled.  All 
important  in  this  process  is  the  vertical  movement  of  the 
ground  water,  and  it  is  certainly  true  that  over  a  long 
period  of  years  of  observation  at  Mimich  there  was  a 
most  remarkable  coincidence  between  epidemics  of  typhoid 

fever  and  fluctuations  in  the  ground-water  level 

Concerning  the  relations  of  cholera  to  the  soil  there  is  but 
little  to  be  said.  Prior  to  the  discovery  of  the  specific 
organism,  the  soil  theory  of  the  origin  of  epidemic  out- 
breaks had  considerable  vogue;  but  now  it  is  known  that, 
even  in  times  of  greatest  prevalence  of  the  disease,  the 
organism  has  never  been  found  under  natural  conditions 
in  the  soil.  It  can  be  kept  alive  under  certain  favorable 
conditions  of  moisture  and  heat  for  varying  periods;  but 
under  natural  conditions  it  is  one  of  the  least  resistant 
bacteria  and  quickly  dies.    We  have  no  evidence  whatever 

that  cholera  is  a  soil  disease With  regard  to 

the   connection  which  may  exist  between  the   soil  and 


19 


158  PHYSIOLOGY  AND  HYGIENE. 

dysentery,  concerning  the  organism  of  which  we  are  in  the 
dark,  it  is  best  to  admit  frankly  that  ive  do  not  know^ 
rather  than  to  make  general  statements  based  on  imagin- 
ings  Beyond  the  observance  of  a  few  coinci- 
dences, no  connection  has  been  proved  to  exist  between 
diarrhoea  and  the  soil."  (Harrington's  Practical  Hygiene.) 
(c)  Proper  drainage;  and  see,  too,  Egbert's  Hygiene  and 
Sanitation,  page  88. 

VII.  PERSONAL  HYGIENE. 
1.  Bathing. 

727.  State  the  value  of  piiblic  haths  to  the  health  of  a  large 
city.     (May,  1899.) 

727.  Under  proper  inspection  for  excluding  persons 
suffering  from  obvious  contagious  diseases,  and  with  other 
common-sense  precautions,  they  are  of  great  value  in 
promoting  cleanliness  and  health  among  the  poorer  popula- 
tion, particularly  in  hot  weather.  But  if  any  precautions 
be  neglected,  they  may  become  prolific  sources  of  disease. 

728.  Give  the  physiological  effects  of  (a)  cold  haths,  (b) 
warm  haths.     (May,  1901.) 

728.  (a)  ''Cold  bathing  is  essentially  stimulant;  the 
cutaneous  vessels  contract  at  once,  and  send  the  superficial 
blood  supply  inward;  the  respiration  is  momentarily  gasp- 
ing in  character,  and  then  slowed  and  increased  in  depth. 
The  whole  nervous  system  and  all  of  the  mental  faculties 
receive  an  immediate  powerful  stimulus.  The  pulse  is 
somewhat  slowed.  On  emerging  from  the  cold  water,  the 
respiration  and  pulse  return  to  their  normal  rates,  the 
cutaneous  vessels  relax  and  dilate,  and  the  return  of  the 
blood  in  increased  volume  to  the  surface  gives  a  sensation 
of  warmth,  which  is  increased  by  the  process  of  'rubbing 
down.'  This  is  known  as  the  'normal  reaction.' ' '  (Harring- 
ton's Practical  Hygiene.)     (b)  "Warm  and  hot  bathing 


159  PHYSIOLOGY  AND  HYGIENE. 

cause  dilatation  of  the  cutaneous  vessels  and  more  or  less 
profuse  perspiration.  Respiration  and  pulse  are  increased 
in  frequency,  and  a  general  soothing  effect  is  produced. 
Hot  bathing  is  a  most  grateful  means  of  reducing  soreness 
of  the  muscles  after  violent  exercise,  and  a  valuable 
assistant  in  the  treatment  of  insomnia.''  (Harrington's 
Practical  Hygiene.) 

729.  (a)  What  are  the  henefits  and  (b)  ivhat  the  dangers 
of  the  Turkish  hath?    (September,  1896.) 

730.  (b)  Mention  some  of  the  dangers  of  the  Turkish  hath. 
(May,  1893.) 

731 .  (b)  What  physical  conditions  would  render  the  taking 
of  a  Turkish  hath  inadvisable?    Why?    {June,  1895.) 

729  to  731.  (a)  1.  Cleansing.  2.  '^When  the  skin  or 
Mdneys  are  torpid,  to  aid  in  the  elimination  of  impure  and 
effete  materials  from  the  blood  and  tissues."  (Hare's 
Practical  Therapeutics.)  (b)  Dangers  are  overheating,  and 
cardiac  failure;  therefore  very  corpulent  people  or  those 
suffering  from  heart  disease  should  take  them  only  by 
medical  advice  or  not  at  all. 

732.  State  physical  conditions  that  make  the  practice  of 
taking  hot  baths  inadvisable.    Give  reasons.     (April,  1896.) 

732.  Organic  diseases  of  the  heart  and  brain,  aneurysm, 
acute  inflammations,  and  tuberculosis;  and  see  Q.  728  (b), 
and  729  to  731  (b). 

2.  Exercise. 

733.  Discuss  the  healthfulness  of  bicycle  riding.  (June, 
1895.) 

733.  '' Wheeling  involves  very  largely  the  entire  mus- 
cular system,  and  brings  into  play  groups  of  muscles  the 
existence  of  which  has  not  before  been  appreciated  by  the 
beginner.  With  the  wheel,  one  may  take  any  desired 
amount  of  gentle,  moderate,  or  violent  exercise.  It  gives 
a  constant  change  of  scene  and  the  pleasurable  sense  of 


160  PHYSIOLOGY  AND  HYGIENE. 

motion,  both  of  which  are  of  value  to  the  tired  mind.  It 
is  not  the  particular  form  of  muscular  exertion  that  is  the 
incentive  to  long  exercise  on  the  wheel,  but  the  pleasure 
which  it  gives.''     (Harrington's  Practical  Hygiene.) 

734.  Give  an  opinion  and  the  reasons  therefor  as  to  whether 
bicycling  or  horseback  riding  is  the  preferable  method  of 
reducing  obesity  in  a  male  patient.    (September,  1896.) 

734.  Bicycling  is  probably  preferable,  inasmuch  as  it 
brings  into  play  a  greater  number  of  muscles,  and  as  it 
means  more  muscular  action  it  also  involves  more  rapid 
oxidation  of  the  tissues. 

735.  Give  the  diet  and  the  exercise,  etc.,  required  physio- 
logically in  the  process  of  skilful  training  for  physical  contests. 
{January,  1897.) 

735.  The  following  '^studies"  of  the  Harvard  Crews  are 
quoted  in  Thompson's  Practical  Dietetics:    ^^  The  men  arose 

at  about  7  o'clock After  a  short  run  breakfast 

was  served  at  7.30  o'clock  and  was  quite  a  hearty  meal, 
consisting  principally  of  oranges,  a  breakfast  cereal,  hot 
meat  or  fish,  and  potatoes.  During  the  morning  there  was 
usually  a  practice  row  on  the  river,  followed  by  a  light 
lunch  at  about  11.30  to  12  o'clock.  The  principal  meal  of 
the  day  was  taken  early  in  the  afternoon.  In  the  late 
afternoon  the  crew  had  another  season  of  hard  work  on 
the  river,  after  which  another  hearty  meal  was  served. 
Leisure  time  was  spent  in  study  or  recreation."  .... 
''The  diet  allowed  was  a  very  generous  one,  consisting  of 
a  hearty  breakfast  at  7.30,  lunch  at  1,  and  dinner  after 
the  evening  row.  For  breakfast  the  fare  consisted  of  fruit, 
oatmeal  or  shredded  wheat,  eggs,  some  form  of  meat, 
bread  and  butter,  potato,  and  milk.  At  noon  there  was 
cold  meat,  potato,  bread  and  butter,  marmalade,  preserved 
fruit,  and  milk.  Dinner  comprised  soup,  occasionally  fish, 
roast  beef  or  some  other  hot  meat,  several  vegetables, 
bread  and  butter,  and  a  simple  dessert.  No  tea  or  coffee 
was  allowed,  but  ale  or  claret  was  permitted  at  dinner, 


161  PHYSIOLOGY  AND  HYGIENE. 

also  water  in  small  amounts,  as  desired.  During  the  last 
week  before  the  race  each  man  received  a  dish  of  calf's 
foot  jelly  with  sherry  wine  after  the  morning  row,  and  a 
light  lunch  of  oatmeal,  milk,  and  bread  was  served  at 
4  o'clock  in  the  afternoon.'' 

736.  Mention  some  of  the  exercises  that  injuriously  affect 
the  heart.  State  the  reasons  for  your  conclusion.  (January, 
1900.) 

736.  Overindulgence  in  almost  any  form  of  exercise, 
particularly  running,  wrestling,  cycling,  and  rowing,  may 
cause  hypertrophy  and  dilatation  of  the  heart. 

737.  What  physical  training  would  you  recommend  for 
'persons  with  weak  respiration?     {January,  1894.) 

737.  Active  walking,  calisthenics,  and  particularly  dumb- 
bell and  Indian  club  exercises.  Later,  slow  running,  in 
moderation. 

738.  How  does  overexertion  affect  the  body  tissues?  {Mayt 
1899.) 

738.  ^' While  the  metabolic  changes  during  violent  exer- 
cise doubtless  produce  toxins — ^fatigue  products' — affecting 
the  nutrition  of  the  heart,  and  causing  relaxation  of  its 
tonus,  the  effects  are  largely  mechanical.  The  heart  is 
called  upon  to  do  more  work  than  when  at  rest,  to  receive 
and  send  out  more  blood,  and  to  do  this  imder  different 

conditions  of  blood  pressure  and  nutrition The 

peripheral  blood  pressure  shows,  during  active  exercise,  a 
temporary  increase,  which  is  followed,  even  if  the  exercise 
continues,  by  a  very  marked  decrease.  In  a  recent  exami- 
nation of  the  contestants  in  a  twenty-five-mile  running 
race,  this  fall  was  invariably  present  in  men  examined  at 
the  finish,  and  was  shown  by  direct  study  of  the  blood 
pressure  and  by  the  sphygmograph.  The  temporary  rise 
is  due  to  increased  output  of  the  heart.  The  pressure 
of  the  muscles  of  the  extremities  on  the  large  veins,  the 
sunilar  action  of  the  muscles  of   the  abdomen  and  dia- 


162  PHYSIOLOGY  AND  HYGIENE. 

phragm  on  the  portal  system,  and  the  increased  activity 
of  the  respiratory  apparatus,  all  favor  the  flow  of  blood 
to  the  right  auricle,  and  through  the  lungs  to  the  left  heart. 
For  a  while  the  increased  output  causes  an  increase  in 
arterial  tension  and  increased  work  for  the  left  ventricle, 
but  there  is  soon  a  dilatation  of  the  peripheral  vessels, 
especially  in  the  muscles,  and  a  consequent  fall  of  pressure 
with  relief  to  the  left  heart.  According  to  Allbutt,  when  this 
adjustment  is  accomplished  the  phenomenon  of  'second 
wind' occurs."  (Reference  Handbook  of  the  Medical  Sciences.) 

739.  State  some  of  the  sequelce  of  (a)  overstrain,  (b)  over- 
exertion, (c)  overtraining.     (April,  1896.) 

739.  (a)  Fractures,  dislocations,  hernia,  apoplexy,  dis- 
ease or  rupture  of  heart,  muscles,  or  ligaments,  (b)  See  Q. 
738  and  929  (b).  (c)  Loss  of  appetite,  digestive  disturb- 
ances, mental  and  bodily  weakness. 

7Jfi,  What  is  the  physical  training  for  a  weak  heart  when 
no  valvular  lesions  exist t     (November,  1893.) 

740.  See  A.  to  737. 

3.  Clothing. 

741 .  What  are  the  respective  merits  of  cotton,  wool,  and  silk 
tvhen  used  in  underwear?    (June,  1896.) 

7U2.  What  arguments  can  be  advanced  in  favor  of  wool 
as  material  for  winter  clothing?    (September,  1902.) 

741  and  742.  Egbert's  Hygiene  and  Sanitation,  pages 
289  and  290. 

VIII.  OCCUPATION. 

743.  Mention  some  of  the  diseases  induced  by  industrial 
pursuits  and  give  the  special  cause  in  each  disease  mentioned. 
(January,  1902.) 

744.  Name  some  of  the  occupations  most  injurious  to 
health  and  give  the  reasons  for  so  classifying  them.  (June, 
1892.) 


163  PHYSIOLOGY  AND  HYGIENE. 

74^.  Mention  some  of  the  diseases  to  which  artisans  are 
specially  liable.     (May,  1898.) 

74.6.  In  the  -pursuits  of  what  trades  is  there  a  predisposition 
to  pulmonary  diseases?     {June,  1894-) 

743  to  746.  ''Pulmonary  phthisis:  accountants,  book- 
keepers, clerks,  compositors,  pressmen,  marble  and  stone- 
cutters. Fibroid  phthisis,  from  dust :  grinders,  file-cutters, 
potters,  glass  pohshers,  wool  and  cotton  spinners,  mil- 
lers. Anthrax:  skin  handlers.  Internal  anthrax:  wool 
and  rag  sorters.  Glanders  and  tetanus :  hostlers.  Anaemia, 
gastric  ulcer,  eczema, erythema  nodosum:  domestic  servants 
(female) .  Varicose  veins :  coachmen,  shop-girls,  and  others 
accustomed  to  long  maintenance  of  the  standing  or  part- 
standing  position.  Writers'  cramp  (scriveners'  palsy): 
clerks  and  writers.  Septic  infection :  butchers  and  slaughter- 
house employes.  Conjunctivitis:  electric-light  workers 
(probably  caused  by  actinic  rays).  Nystagmus:  miners. 
Emphysema:  players  upon  wind  instruments.  Insomnia, 
dyspepsia,  disease  of  liver  and  kidneys,  neurasthenia, 
irritable  heart,  apoplexy,  and  paralysis:  brain  workers. 
Typhoid  fever,  pneumonia,  cardiovascular  and  renal  dis- 
ease, morphine  and  cocaine  habits:  physicians.  Lead 
poisoning:  lead  miners  and  smelters,  painters,  gilders, 
makers  of  white  and  red  lead,  seamstresses  (from  silk 
thread  loaded  with  acetate  of  lead),  makers  of  artificial 
flowers.  Mercurial  poisoning:  cinnabar  miners,  makers  of 
cheap  looking-glasses  or  mirrors,  and  makers  of  felt 
hats.  Arsenical  poisoning:  wall-paper  workers  (formerly), 
workers  on  artificial  flowers  and  fancy  glazed-paper  boxes. 
Phosphorus  poisoning :  matchmakers.  Chromium  and  zinc 
poisoning:  'founders'  ague'  in  brass  foundries.  Disease  of 
hair  follicles :  operatives  in  oil  refineries  and  paraflin  works." 
(Butler's  Diagnostics  of  Internal  Medicine.) 

747.  Mention  the  effects  of  working  in  phosphorus,  as  in 
the  manufacture  of  phosphorus  matches.  How  can  the 
dangers  he  limited  or  prevented?    (January,  1899.) 


164  PHYSIOLOGY  AND  HYGIENE. 

747.  ^'  In  chronic  poisoning  by  phosphorus,  when,  by  the 
inhalation  of  its  fumes,  systemic  changes  occur,  the  most 
common  lesion  is  necrosis  of  the  lower  jaw,  which  may  be 
widespread  or  limited.  It  never  occurs  in  those  who  have 
no  solution  of  continuity  in  the  teeth  or  gums,  and  for  this 
reason  it  is  necessary  that  the  employes  in  match  factories 
should  have  their  teeth  and  gums  constantly  attended  to. 
It  has  been  said  that  pans  containing  turpentine  when  set 
around  the  work-room  will  protect  the  workmen,  but  this 
is  certainly  incorrect."  (Hare's  Practical  Therapeutics.) 
In  addition  it  may  be  stated  that  red  phosphorus  is  much 
less  toxic  than  the  yellow  form. 

748.  (a)  What  occupations  are  a  menace  to  public  health? 
(b)  Whyf     (June,  1898.) 

748.  (a)  The  chief  occupations  that  are  a  menace  to 
public  health  are:  blood  boiling,  bone  boiling,  tripe  boil- 
ing, soap  boiling,  tallow  melting,  and  fellmongering. 

(Id)  The  chief  sources  of  nuisance  are :  filthy  and  imsuit- 
able  premises,  offensive  vapors,  improper  storage  of  mate- 
rial, improper  disposal  of  waste  or  refuse  material. 

749.  Name  two  important  industries  the  presence  of  which 
is  prejudicial  to  health  in  large  cities?    (March,  1892.) 

749.  Smelting  and  chemical  manufactures. 

750.  Give  the  special  hygiene  of  factories  in  which  women 
and  children  are  employed.     (January,  1892.) 

750.  In  addition  to  the  ordinary  hygiene  of  factories 
and  workshops,  such  as  proper  space,  air,  ventilation, 
lighting,  heating,  and  ordinary  cleanliness,  care  should  be 
taken  that  women  and  children  do  not  work  too  long  at 
a  time  or  at  occupations  involving  the  use  of  poisonous 
or  deleterious  materials,  that  there  are  ample  toilet  and 
lavatory  accommodations,  and  that  these  are  separate 
and  away  from  those  used  by  men;  there  should  also  be 
opportunity  to  sit,  and  women  should  not  be  expected  to 
remain  standing  for  long  periods  of  time. 


165  PHYSIOLOGY  AND  HYGIENE. 


IX.  HABITATIONS. 

761.  Describe  briefly  a  proper  location  for  a  dwelling-house 
in  the  country.     (March,  1892.) 

752.  In  the  selection  of  a  site  for  a  dwelling  what  is  the 
best  sanitary  soil,  sub-soil,  and  topography 9  {January,  1892.) 

751  and  752.  '^  One  of  the  first  requirements  of  a  sanitary 
home  is  a  salubrious  building  site  with  a  thorough  exposure 
to  air  and  sunlight;  the  top  of  a  small  elevation  is  always 
to  be  preferred,  because  of  better  natural  drainage,  purer 
air,  freedom  from  dampness,  and  greater  safety  from 
inundations.  The  tops  of  the  highest  hills  are  usually  too 
much  exposed  to  the  wind,  and  when  chosen  in  certain 
climates  the  house  should  be  protected  by  trees  on  the 
windward  side;  next  to  the  top  of  a  hill,  the  slopes  should 
be  preferred  with  a  southern,  southeastern,  or  southwestern 
exposure,  on  account  of  the  advantages  of  sunlight  and 
greater  cheerfulness.  Sites  located  in  depressions  which 
receive  the  natural  drainage  from  surrounding  slopes 
should  be  avoided,  as  they  are  not  only  damp,  but  likely 
to  be  surrounded  with  cold  air  and  chilling  mists.  It  is 
scarcely  necessary  to  insist  that  so-called  ^made  soil'  and 
close  proximity  to  marshes  and  injurious  industrial  estab- 
lishments should  be  avoided.  Next  to  the  topography  of 
the  site  the  character  of  the  soil  is  important  in  its  influence 
upon  the  healthfulness  of  the  home.  In  a  general  way  a 
gravelly,  sandy,  or  chalky  soil  of  good  depth  on  a  slope 
makes  the  best  building  site,  provided  soil  pollution  has  not 
taken  place  and  the  deposit  is  not  upheld  by  some  imper- 
meable stratum  of  clay  or  rock  near  the  surface.  Clay, 
marl,  peat,  and  made  soils  should  be  avoided,  because  they 
are  damp  and  the  presence  of  organic  matter,  apart  from 
favoring  the  proliferation  of  disease  germs,  also  tends  to 
pollute  the  ground  air  which  is  in  constant  communication 
and  interchangeable  with  the  atmosphere.''  {Reference 
Handbook  of  the  Medical  Sciences.) 


20 


166  PHYSIOLOGY  AND  HYGIENE. 

758.  Is  green  wall  paper  objectionable?  If  so,  whyf 
(January,  1898.) 

753.  Yes;  because  it  may  contain  arsenic  which  is  liable 
to  become  detached  from  the  paper,  and  may  be  present 
in  the  air  of  the  room,  and  then  be  inhaled. 

754'  What  are  the  near  and  remote  effects  of  too  much 
shade  around  a  dwelling-house?    {April,  1893.) 

755.  Name  the  chief  objections  to  the  presence  of  shade 
trees  near  a  divelling-house.    (April,  1895.) 

756.  Mention  the  dangers  of  excessive  shade  about  dwellings. 
{September,  1898.) 

754  to  756.  Shade  favors  dampness  and  the  m\iltiplica- 
tion  of  molds  and  bacteria,  which  are  readily  carried  by  the 
ground  air  into  the  house.  Apart  from  this,  absence  of 
sunlight  is  an  important  cause  of  anaemia  and  debility. 
See,  too,  Egbert's  Hygiene  and  Sanitation,  pages  294  et  seq. 

757.  Give  some  of  the  requisites  for  the  sanitary  construc- 
tion of  house  foundations  and  cellars.    (September,  1893.) 

757.  Egbert's  Hygiene  and  Sanitation,  page  88. 

758.  The  excavation  of  streets  in  cities  is  frequently 
followed  by  the  outbreak  of  diseases  such  as  diphtheria  and 
typhoid;  what  is  the  cause?     (May,  189 J/..) 

758.  It  exposes  to  the  drying  action  of  the  air,  soil  which 
contains  these  bacteria  in  quiescent  state.  The  dust  result- 
ing is  carried  about  and  is  taken  in  with  the  air  and  food 
which  it  thus  infects. 

759.  How  may  pathogenic  micro-organisms  be  conveyed 
from  the  soil  and  produce  disease?    Illustrate.    (May,  1902.) 

759.  See  Q.  758;  and  Egbert's  Hygiene  and  Sanitation, 
pages  88  and  89. 

760.  Mention  certain  diseases  produced  by  damp  soils  and 
ground  water.     (January,  1895.) 

760.  It  is  doubtful  in  the  light  of  present  knowledge  if 
these  directly  cause  disease,  but  they  are  important  factors 


167  PHYSIOLOGY  AND  HYGIENE. 

in  the  etiology,  notably  of  rheumatism,  malaria,  typhoid 
and  intestinal  disorders.    See,  too,  A.  725  (b). 

761.  What  diseases  may  arise  from  soil  pollution?  (Sep- 
tember, 1899.) 

761.  Egbert's  Hygiene  and  Sanitation,  pages  92  and  98. 

762.  Describe  the  best  method  of  ventilating  dwellings. 
{January,  1892.) 

762.  Egbert's  Hygiene  and  Sanitation,  page  115. 

763.  Describe  a  system  of  ventilation  for  a  large  public 
building.     {April,  1894.) 

763.  Egbert's  Hygiene  and  Sanitation,  page  119. 

764.  In  what  part  of  an  occupied  room  is  the  most  impure 
air  found?    Explain.     {September,  1902.) 

764.  Egbert's  Hygiene  and  Sanitation,  page  115. 

765.  What  should  be  the  proper  temperature  for  a  living 
room  in  winter?     {January,  1893.) 

765.  Egbert's  Hygiene  and  Sanitation,  page  123. 

766.  Give  an  opinion  as  to  the  sanitary  effects  of  the 
different  methods  of  heating  houses.    {May,  1898.) 

767.  From  the  standpoint  of  pure  air,  what  are  the  advan- 
tages and  disadvantages  of  heating  by  (1)  open  fires,  (2) 
stoves,  (3)  hot  pipes,  (4)  mechanical  ventilation?  {June, 
1901.) 

766  and  767.  Egbert's  Hygiene  and  Sanitation,  pages 
125  et  seq.,  and  119. 

768.  State  some  of  the  results  to  animal  life  of  the  combustion 
of  artificial  fuel  in  a  room  without  chimney  connection  or 
other  ventilation.     {June,  1893.) 

768.  Egbert's  Hygiene  and  Sanitation,  page  95. 

769.  What  principal  means  are  employed  for  producing 
artificial  light  in  dwellings  and  what  are  their  relative  advan- 
tages?   {September,  1901.) 

769.    Egbert's  Hygiene  and  Sanitation,  pages  83  to  85. 


168  PHYSIOLOGY  AND  HYGIENE. 

X.  SCHOOLS. 

770.  (a)  What  is  the  minimum  number  of  cubic  feet  of 
atmosphere  which  should  be  allowed  to  each  pupil  in  a  public 
school-room?     (June,  1892.) 

771.  (b)  State  the  minimum  of  cubic  space  to  which 
children  should  be  subjected  in  the  school-room.  {September, 
1892.) 

770  and  771.  (a)  1800  cubic  feet  of  fresh  air  per  hour; 
(b)  150  cubic  feet  of  space,  15  square  feet  of  floor  space. 

772.  Describe  a  system  of  school  ventilation.  {September, 
1900.) 

772.  Egbert's  Hygiene  and  Sanitation,  page  308. 

773.  In  what  position  would  you  place  the  desk  and  bench 
of  a  school  child  in  respect  to  the  admission  of  light?  {May, 
1893.) 

773.  Egbert's  Hygiene  and  Sanitation,  page  307. 

774.  What  deformities  are  liable  to  result  from  improperly 
constructed  desks  and  seats  in  school-rooms?  {November, 
1891.) 

774.  Compression  of  the  thorax,  spinal  curvature,  round 
shoulders;  and  see  Egbert's  Hygiene  and  Sanitation,  page 
305. 

775.  (a)  What  abnormal  conditions  of  the  eyes  is  most 
common  in  school  children?     {November,  1892.) 

776.  (b)  What  habits  of  school  children  tend  to  produce 
myopia?     {January,  1893.) 

777.  (c)  What  directions  to  prevent  defects  of  vision  should 
be  given  children  attending  school?    {September,  1896.) 

775  to  777.  (a)  Myopia,  hypermetropia,  astigmatism,  stra- 
bismus, and  trachoma,  (b)  Reading  of  fine  or  indistinct 
print,  reading  in  poor  illumination,  improper  positions  in 
reading  or  writing,  using  the  eyes  when  tired;  excessive 
study,  particularly  when  accompanied  by  insufficient  exer- 
cise, is  also  conducive  to  myopia,    (c)  Avoidance  of  (b). 


169  PHYSIOLOGY  AND  HYGIENE. 

778.  What  are  the  usual  systemic  effects  ^produced  on  grow- 
ing children  in  attendance  at  a  school  where  light  is  insufficient 
and  poorly  distributed  and  where  ventilation  is  had?  (May, 
1898.) 

778.  Egbert's  Hygiene  and  Sanitation,  page  300. 

779.  (a)  What  diseases  common  to  children  may  he  traced 
to  school  attendance  and  school  associations?  (September, 
1899.) 

780.  (a)  Name  the  principal  diseases  incident  to  school 
life.    (January,  1896.) 

781 .  (b)  Mention  the  most  common  communicable  diseases 
of  school  children.     (January,  1898.) 

782.  (a)  What  diseases  are  incident  to  school  life?  (c) 
HoiD  may  these  diseases  be  prevented?    (September,  1900.) 

779  to  782.  (a)  Egbert's  Hygiene  and  Sanitation,  pages 
300  to  305,  and  314;  and  ringworm,  pediculi,  eyestrain,  and 
diphtheria,  (b)  Egbert's  Hygiene  and  Sanitation,  page 
314 ;  and  diphtheria,  pedicuh,and  ringworm,  (c)  By  proper 
hygiene  of  the  school-room,  including  warmth,  light, 
ventilation,  and  disinfection;  limiting  the  amount  of  work 
to  be  done  at  home;  suitable  desks  properly  arranged; 
frequent  medical  inspection  and  prompt  exclusion  of  chil- 
dren who  are  ill,  with  quarantine  of  persons  exposed  to 
infectious  diseases. 

78S.  State,  in  a  general  way,  the  maximum  number  of 
hours  a  day  that  primary  pupils  in  the  public  schools  be  kepi 
at  their  tasks,  and  how  frequently  and  in  what  manner  such 
tasks  should  be  varied  and  broken.    (January,  1895.) 

783.  Each  lesson  should  last  not  longer  than  half  an  hour, 
when  the  subject  should  be  changed.  At  the  end  of  each 
hour  there  should  be  an  intermission  of  five  or  ten  minutes. 
The  whole  morning  session  should  not  exceed  three  hours. 
After  a  two  hours'  recess  for  lunch  and  recreation  the  after- 
noon session  should  follow,  with  tasks  limited  as  before. 

784.  Give  the  sanitary  dimensions  of  a  school  class-room 
for  50  pupils.     (May,  1895.) 


170  PHYSIOLOGY  AND  HYGIENE. 

784.  The  room  should  be  40  feet  long,  30  feet  wide,  and 
15  feet  high;  this  will  allow  360  cubic  feet  of  space  for  each 
pupil. 

785.  Describe  in  detail  the  hygienic  characteristics  of  a 
model  school-room  accommodating  50  'pupils.    {May,  1902.) 

786.  Describe  conditions  necessary  to  make  a  school-house 
sanitary.     (September,  1901.) 

787.  What  hygienic  defects  should  be  guarded  against  in 
the  construction  of  school  buildings?    {January,  1900.) 

785  to  787.  Egbert's  Hygiene  and  Sanitation,  pages  307 
to  311. 

XI.  HOSPITALS. 

788.  Describe  a  simple  form  of  extemporized  ventilation  in 
a  sick-room,  by  windows,  doors,  or  otherwise.  {September, 
1894.) 

788.  Egbert's  Hygiene  and  Sanitation,  pages  113  and 
114. 

789.  How  should  a  hospital  be  ventilated  and  heated f 
(January,  1900.) 

790.  What  should  be  the  hygienic  characteristics  of  a 
hospital  ward?    (May,  1900.) 

791.  Give  the^pecial  hygiene  of  hospital  wards.  (January, 
1892.) 

789  to  791.  Egbert's  Hgyiene  and  Sanitation,  pages  113 
and  114,  119  to  123,  and  140  to  142. 

792.  Discuss  detached  wards  versus  many-storied  buildings 
for  a  proposed  hospital.    (September,  1895.) 

792.  The  detached-ward  plan  is  much  the  preferable,  as 
infection  can  be  more  perfectly  localized,  and  patients  will 
not  be  subject  to  the  baneful  effects  upon  vitality  conse- 
quent upon  superimposition.  I«i  detached  wards  the 
ventilation  is  better,  supervision  easier  and  more  efficient, 
and  in  case  of  fire  the  patients  can  be  removed  quicker. 
See,  too,  Egbert's  Hygiene  and  Sanitation,  page  404,  under 
^'Barracks." 


171  PHYSIOLOGY  AND  HYGIENE. 

793.  Give  the  requisites  of  a  good  site  for  a  quarantine 
hospital.     (June,  1898.) 

793.  Egbert's  Hygiene  and  Sanitation,  page  352. 

794.  Outline  the  construction  of  a  camp  hospital,  especially 
providing  for  the  care  {with  least  danger  to  other  patients, 
medical  and  surgical)  of  those  suffering  from  contagious 
diseases.    {May,  1901.) 

794.  Egbert's  Hygiene  and  Sanitation,  page  404;  in 
addition  the  wards  should  be  detached;  there  should  be 
ample  provision  for  burning  all  discharges,  dejecta,  dress- 
ings, and  infected  material ;  fresh  air,  sunlight,  heating  and 
ventilation  are  prime  requisites. 

XII.  DISPOSAL  OF  SEWAGE. 

795.  What  is  (a)  drainage,  (b)  sewerage?  What  should 
he  the  characteristics  of  (c)  drainage  pipes,  (d)  sewerage 
pipes?    Explain.     {June,  1902.) 

796.  Explain  (a)  drainage,  (e)  sewage,  and  (b)  sewerage, 
{May,  1896.) 

795  and  796.  (a)  Drainage  is  the  removal  of  the  surface 
and  soil  water.  See  also  Egbert's  Hygiene  and  Sanitation, 
page  368  et  seq.  (b)  Sewerage  is  the  process  of  systematically 
collecting  and  removing  sewage  from  dwellings  and  other 
buildings,  (c)  Egbert's  Hygiene  and  Sanitation,  page  371; 
(d)  page  369  (Soil-pipe);  (e)  pages  363  and  364. 

797.  What  is  the  most  sanitary  way  of  disposing  of  city 
garbage?     {January,  1893.) 

797.  Egbert's  Hygiene  and  Sanitation,  pages  363  and 
364. 

798.  What  is  the  best  sanitary  disposition  of  stable  manure 
in  large  cities?     {April,  1895.) 

799.  Describe  the  best  way  of  disposing  of  stable  manure 
in  cities.     {November,  1892.) 

798  and  799.  The  liquid  part  should  be  properly  drained 
into  the  sewer,  and  the  solid  manure  should  be  cremated' 


172  PHYSIOLOGY  AND  HYGIENE, 

or,  if  this  latter  is  impossible,  it  should  be  stored  in  properly- 
covered  receptacles  or  pits,  care  being  taken  to  keep  out 
rain  or  other  water,  and  then  at  frequent  and  regular 
intervals  it  should  be  taken  into  the  country  to  be  employed 
for  agricultural  purposes;  it  is  important  to  keep  it  as  dry 
as  possible. 

800.  (a)  What  is  sewer  gasf  (b)  How  does  the  inhalation 
of  sewer  gas  in  large  quantities  affect  the  system?  {April, 
1898.) 

801.  (b)  What  evil  effects  may  result  from  inhaling  sewer 
gases?    {January,  1901.) 

800  and  801.  (a)  Egbert's  Hygiene  and  Sanitation,  page 
86;  (b)  page  98. 

802.  What  is  the  best  means  for  preventing  the  access  of 
sewer  gas  in  dwellings?    {June,  1893.) 

802.  Egbert's  Hygiene  and  Sanitation,  page  374  et  seq. 

80S.  How  does  sewage  become  dangerous  to  health?  {June, 
1898.) 

803.  After  a  short  time  decomposition  takes  place,  and 
noxious  gases  are  given  off;  and  in  some  cases  specific 
germs  of  disease  are  found  in  the  excreta.  Water  and  air 
are  both  polluted,  and  both  may  be  the  means  of  convey- 
ing disease  to  the  system.  See,  too,  Egbert's  Hygiene  and 
Sanitation,  pages  98  and  152. 

804.  Give  approved  methods  of  sewage  disposal.  {May, 
1900.) 

805.  What  is  the  best  sanitary  plan  for  the  disposal  of 
sewage?     {November,  1891.) 

806.  Outline  a  method  for  the  final  disposal  of  the  sewage 
of  cities.     {January,  1902.) 

804  to  806.  Egbert's  Hygiene  and  Sanitation,  pages  391 
to  399. 

807.  In  what  way  can  the  sewage  of  a  city  be  best  utilized? 
{September,  1893.) 


173  PHYSIOLOGY  AND  HYGIENE. 

807.  Egbert's  Hygiene  and  Sanitation,  pages  393  and 
394. 

808.  Describe  the  essential  features  of  a  satisfactory  system 
of  house  sewage.     {May,  1899.) 

808.  Egbert's  Hygiene  and  Sanitation,  pages  368  to  386. 

809.  (a)  What  evils  arise  from  outside  'privy  vaults?  (b) 
How  may  such  evils  he  averted  in  cases  where  outside  privy 
vaults  cannot  he  supplanted  hy  more  modern  contrivances? 
{Septemher,  1898.) 

810.  (b)  How  may  a  privy  in  city  or  country  he  kept 
while  in  use  from  becoming  a  nuisance?    {April,  1895.) 

809  and  810.  (a)  The  air  in  their  vicinity  becomes 
saturated  with  noxious  odors;  their  contents  overflow, 
saturate  the  ground  in  the  neighborhood,  and  possibly 
find  their  way  into  wells,  (b)  Egbert's  Hygiene  and 
Sanitation,  page  366. 

XIII.  DISINFECTION. 

811.  Define  (a)  disinfectant,  (b)  deodorant,  (e)  germicide, 
(c)  antiseptic,  (f)  aseptic,  (g)  fomites,  (d)  quarantine. 
{September,  1899.) 

811.  Egbert's  Hygiene  and  Sanitation,  (a)  page  317; 
(b)  page  318;  (c)  page  318;  (d)  page  344;  (e)  a  substance 
capable  of  destroying  bacteria;  (f)  absence  of  germs;  (g) 
substances  capable  of  conveying  contagion. 

812.  Mention  in  order  of  importance  the  different  physical 
and  the  different  chemical  agents  that  are  used  for  disinfection. 
{September,  1902.) 

812.  Egbert's  Hygiene  and  Sanitation,  pages  339  and 
321  to  337. 

813.  What  is  the  lowest  temperature  of  steam  heat  at  which 
pus  cocci  are  destroyed?     {January,  1894.) 

813.  Egbert's  Hygiene  and  Sanitation,  page  321. 


21 


174  PHYSIOLOGY  AND  HYGIENE. 

814'  (a)  Describe  a  desirable  operating-table,  (b)  Mention 
the  essentials  for  properly  safeguarding  the  patient  from  septic 
influences  during  and  after  an  operation  for  amputation  of 
the  foot.     (September,  1897.) 

815.  (b)  Describe  the  preparation  of  patient,  surgeon, 
assistants,  instruments,  and  surroundings  for  operative  pro- 
cedures.    (January,  1900.) 

814  and  815.  (a)  It  should  be  made  of  forged  iron  or 
steel  frame,  with  glass  top  properly  guttered  for  drainage. 
Its  construction  should  be  of  medium  weight,  but  very  rigid. 
All  metal  should  be  finished  in  baked  enamel.  Its  top 
should  be  capable  of  tilting  to  an  angle  of  45°  in  either 
direction,  and  the  mechanism  for  accomplishing  this  should 
be  simple,  strong,  and  operable  with  one  hand.  It  should 
be  furnished  with  leg  holders  and  other  appliances  for 
supporting  the  patient  in  any  of  the  ordinary  operating 
positions,  and  should  move  freely  upon  castors,  (b)  The 
operating-room  should  be  as  devoid  of  furnishings,  hangings, 
etc.,  as  possible,  and  should  be  freely  ventilated,  light,  and 
warm.  Its  floor  and  walls  should  be  frequently  scrubbed 
and  washed  with  antiseptics.  Windows,  when  open,  should 
be  properly  screened  to  prevent  the  ingress  of  insects. 
Instruments  should  be  boiled  for  twenty  minutes  in  5  per 
cent,  soda  solution.  Ligatures  (catgut)  may  be  prepared  by 
any  of  the  usual  methods:  boiling  in  alcohol,  boiling  in 
cumol,  the  formalin  method,  or  soaking  in  potassium-iodide- 
iodine  solution.  Silk  and  silkworm-gut  should  be  repeatedy 
boiled  in  saline  solution.  All  dressings  should  be  sterilized 
by  steam  or  prolonged  immersion  in  bichloride  solution 
1 :  2000.  Paraphernalia  of  the  operating-room  should  be 
wiped  with  a  cloth  dipped  in  bichloride  solution,  1 :  1000, 
shortly  before  operation.  Patient  should,  if  possible, 
receive  a  full  bath  and  a  cathartic  the  night  before  opera- 
tion. The  operation  site  should  be  scrubbed  with  soap  and 
warm  water,  and  an  antiseptic  dressing  applied,  which 
should  be  removed  just  before  operation,  the  site  again 
washed  with  soap  and  water,  followed  by  alcohol,  ether. 


175  PHYSIOLOGY  AND  HYGIENE. 

and  bichloride  solution  1 ;  2000.  The  whole  patient  should 
then  be  covered  by  a  sterilized  sheet  or  sterilized  towels 
securely  pinned  together.  The  surgeon  and  assistants 
should  don  sterilized  caps  and  masks.  The  hands  and 
forearms  should  be  thoroughly  scrubbed  with  soap  and 
running  hot  water  for  five  minutes,  special  attention 
being  paid  to  the  nails,  and  the  subungual  space  cleaned 
by  a  wooden  stick,  then  immersed  in  alcohol  followed  by 
bichloride  1:2000  for  three  minutes,  or  in  a  saturated 
potassium  permanganate  solution,  with  or  without  the 
addition  of  bichloride  1 :  2000.  This  may  remain  on  the 
hands  during  the  operation,  or  the  hands  may  at  once 
be  decolorized  by  saturated  solution  of  oxaUc  acid,  after 
which  they  are  rinsed  in  sterile  saline  or  a  dilute  bichloride 
solution  1: 3000.  The  surgeon  should  then  don  a  sterilized 
gown.  All  subsequent  dressings  should  be  done  under 
antiseptic  precautions  as  regards  wound,  dressings,  instru- 
ments, and  hands. 

816.  Describe  briefly  an  approved  means  for  disinfecting 
a  room.     (March,  1892.) 

817.  Hoiv  should  an  apartment  be  disinfected  after  an 
infectious  disease?     {June,  1899.) 

816  and  817.  Egbert's  Hygiene  and  Sanitation,  pages 
340  to  342. 

818.  Describe  a  process  of  disinfecting  an  infected  hospital 
ward.     (April,  1899.) 

819.  How  should  a  hospital  ward  in  which  there  has 
recently  been  a  case  of  scarlatina  be  disinfected?  (June, 
1900.) 

818  and  819.  Egbert's  Hygiene  and  Sanitation,  pages  341 
to  343. 

820.  State  the  most  approved  means  of  disinfecting  private 
apartments  after  scarlatina.    (January,  1897.) 

820.  See  Q.  817. 

821.  How  should  clothing  and  bedding  used  in  a  case  of 
scarlet  fever  be  disinfected?    (September,  1901.) 


176  PHYSIOLOGY  AND  HYGIENE 

821.  Egbert's  Hygiene  and  Sanitation,  pages  341  and 
342. 

82£.  Hoiv  would  you  disinfect  a  hospital  ward  after  its 
recent  occupation  by  puerperal  diseases?    (November,  1893.) 

822.  See  A.  819;  in  addition,  do  not  use  it  for  surgical 
or  confinement  cases  for  a  period  of  one  month. 

823.  State  the  best  means  of  disinfecting  sputum.  [Janu- 
ary, 1901.) 

823.  ^^In  pneumonia  and  pulmonary  tuberculosis,  the 
sputum  should  be  received  in  spit-cups  partly  filled  with 
disinfectant  solution,  and  kept  covered  when  not  in  actual 
use.  It  may  be  treated  with  5  per  cent,  of  carbolic  acid, 
or  about  5  per  cent,  of  any  of  the  cresol  compounds,  or 
1  per  cent,  of  formaldehyde.  Milk  of  lime  and  chlorinated 
lime  are  also  efficient.  Corrosive  sublimate  is  very  un- 
certain. By  reason  of  its  consistency  and  adhesive  prop- 
erties, sputum  is  one  of  the  most  difficult  materials  to 
sterilize."     (Harrington's  Practical  Hygiene.) 

82Jj..  Describe  a  method  of  disinfecting  (a)  excreta,  (b)  the 
person  of  the  convalescent,  (c)  clothing,  (d)  the  vacated  sick- 
room.    (September,  1900.) 

824.  (a)  See  Q.  825;  (b)  general  hot  water  and  soap  bath 
with  scrubbing,  followed  by  washing  with  diluted  Labar- 
raque's  solution,  or  a  1  per  cent,  carbolic  acid  or  1 :  3000 
bichloride  solution,  nasal  douche  of  warm  saline  with 
listerine  or  some  similar  preparation,  mouth  wash  and 
repeated  gargles  of  the  same,  and  a  complete  change  of 
wearing  apparel;  (c)  see  Q.  821;  (d)  see  Q.  816  and  817. 

825.  Describe  the  procedure  of  disinfecting  and  disposing 
of  typhoid-fever  stools.     (June,  1902.) 

825.  ^'The  discharges  from  the  bowels  in  typhoid  fever, 
dysentery,  cholera,  and  intestinal  tuberculosis  should  be 
received  in  vessels  containing  an  amount  of  disinfectant 
solution  equal  to  or,  better,  larger  than  the  probable 
volume  of  the  discharges.     Whatever  the  agent  used,  it 


177  PHYSIOLOGY  AND  HYGIENE. 

should  be  brought  into  immediate  contact  with  the  entire 
mass  of  the  discharge  by  thorough  mixing,  and  the  whole 
should  stand  under  cover  for  about  an  hour  before  final 
disposition.  Milk  of  lime,  although  efficient,  leaves  a 
bulky  residue,  which  cannot  be  conveniently  disposed  of 
through  the  usual  channels.  Chlorinated  lime  is  also 
efficient,  but  is  disagreeable  in  odor.  Corrosive  sublimate 
is  unsuitable ;  phenol  in  5  per  cent,  solution,  with  or  without 
the  addition  of  mineral  acids  or  common  salt,  and  the 
various  cresol  disinfectants  may  be  employed,  but  their 
odor  is  not  always  tolerable  to  the  patient.  Dilute  formalin 
presents  no  objections,  and  is  very  efficient  and  rapid  in 
action."     (Harrington's  Practical  Hygiene.) 

826.  What  means  would  you  adopt  in  fumigating  and  dis- 
infecting (a)  a  ship  or  (b)  house  in  which  there  had  been  a 
contagious  disease f     (June,  1893.) 

827.  fa)  How  should  a  ship  he  disinfected  in  case  of 
cholera f    (May,  1899.) 

828.  (b)  What  constitutes  ship  or  cargo  disinfection  at  the 
quarantine  stations  in  the  United  States f    (June,  1894.) 

826  to  828.  (a)  Egbert's  Hygiene  and  Sanitation,  pages 
352  to  356;  (b)  pages  330  to  343. 

XIV.  VACCINATION. 

829.  State  the  accepted  belief  in  respect  to  the  limitation  of 
protection  from  vaccination.     (May,  1893.) 

829.  ' '  The  protection  conferred  by  vaccination  is  greatest 
during  the  year  succeeding  the  operation,  and  appears  to 
diminish  gradually  during  the  succeeding  five  or  six  years ; 
but  the  modifying  power  does  not  diminish  equally  fast. 
The  protective  influence  can  be  re-established  by  a  repeti- 
tion of  the  operation,  and  during  epidemics,  or  when  about 
to  visit  countries  where  vaccination  is  not  practised  and 
smallpox  is  endemic,  re  vaccination  is  always  advisable. 
If  the  operation  is  negative  in  its  results,  the  individual  is 


178  PHYSIOLOGY  AND  HYGIENE. 

regarded  as  immune  or  partially  protected;  but  in  the  case 
of  a  first  vaccination  it  is  customary  to  repeat  the  operation 
until  success  is  attained."  (Harrington's  Practical  Hygiene,) 

830.  Which,  in  your  judgment,  is  to  he  preferred  in 
vaccination,  animal  or  humanized  virus,  and  why?  {July, 
1893.) 

830.  Animal  or  bovine  virus  is  to  be  preferred  because  in 
the  use  of  humanized  virus  there  is  a  possibility  of  contami- 
nation with  syphilis  or  other  disease,  and  there  is  a  more 
constant  supply  of  bovine  virus  than  of  humanized  virus. 

831.  What  is  your  view  concerning  the  propriety  or 
necessity  of  inserting  vaccine  virus  in  multiple  places?  {No- 
vember, 1893.) 

831.  It  is  generally  conceded  that  where  the  vaccine 
virus  is  inserted  in  three  or  four  places  the  vaccination  is 
more  effectual  than  where  only  one  or  two  insertions  have 
been  made. 

832.  Describe  the  progressive  changes  in  a  healthy  infant 
after  the  introduction  of  pure  vaccine  beneath  the  skin. 
{April,  1894.) 

832.  ^'When  fresh  vaccine  lymph  is  introduced,  local 
effects  are  not  usually  noticeable  within  the  first  forty- 
eight  hours.  The  period  of  incubation  is  brief,  and  if  the 
vaccination  is  successful,  at  about  the  end  of  the  second 
day  a  slight  redness  and  swelling  are  observed  at  the  seat 
of  insertion.  On  the  third  or  fourth  day  a  little  vesicle 
appears  at  the  summit  of  the  papule,  filled  with  a  clear 
liquid,  which  gradually  grows  larger  and  larger.  As  the 
size  of  the  efflorescence  increases,  an  umbilication  appears, 
similar  to  that  of  the  genuine  variola  pustule,  which  corre- 
sponds to  the  shape  of  the  original  wound  of  insertion ;  an 
insertion  by  simple  puncture  producing  a  circular  vesicle, 
and  an  insertion  by  a  longitudinal  incision  producing  an 
oval  vesicle.  The  vesicle  attains  its  largest  size  about  the 
seventh  or  eighth  day,  when  it  contains  a  clear  liquid, 


179  PHYSIOLOGY  AND  HYGIENE. 

which,  if  the  vesicle  is  punctured,  will  ooze  out  upon  the 
surface  sparingly.  The  construction  of  the  vesicle  is 
cellular,  like  that  of  the  pustule  of  variola.  After  the 
eighth  day,  and  sometimes  a  few  hours  earlier,  a  ring  of 
inflammation  called  the  areola  begins  to  form  about  the 
base,  and  the  vesicle  and  areola  together  continue  for  the 
next  two  days  to  spread.  The  areola  is  circular,  and  when 
fully  developed  has  a  diameter  of  1  to  3  in.  (2^  to  7  cm.).  It 
is  often  attended  with  considerable  hardness  and  swelling 
of  the  subjacent  tissues.  The  establishment  of  the  areola 
demands  attention  as  the  evidence  that  the  specific  effects 
of  vaccinia  have  been  produced.  If  several  insertions  have 
been  made  near  each  other,  the  areolae  coalesce.  After  the 
tenth  day  the  areola  begins  to  fade,  the  vesicle  begins  to 
dry  in  the  centre,  the  lymph  remaining  in  it  becomes 
opaque,  the  pearly  colored  pustule  becomes  yellowish,  while 
at  the  centre,  at  the  location  of  the  original  insertion  of 
the  virus,  a  cr\ist  has  begim  to  form.  By  the  fourteenth 
day  the  crust  has  become  dry  and  hard,  and  gradually 
assumes  a  darker  hue,  and  usually  falls  off  from  the  twen- 
tieth to  the  twenty-fifth  day,  leaving  a  cicatrix,  commonly 
permanent,  which  is  usually  circular,  slightly  depressed, 
foveated,  or  indented  with  minute  pits,  and  sometimes 
radiated.  There  are  also  constitutional  symptoms  more  or 
less  severe,  in  proportion  to  the  intensity  of  the  local  symp- 
toms. There  are  fever,  restlessness,  derangement  of  the 
digestive  organs,  and  occasionally  swelling  of  the  axillary 
glands.  The  constitutional  symptoms  are  usually  most 
severe  at  or  a  httle  before  the  time  when  the  areola  has 
reached  its  fullest  development.''  {Reference  Handbook  of 
the  Medical  Sciences.) 

833.  (a)  State  your  views  on  compulsory  vaccination  and 
(b)  relate  the  safeguards  which  should  he  employed  in  all 
cases  of  vaccination.     {June,  1894.) 

833.  (a)  In  view  of  the  figures  given  in  Egbert's  Hygiene 
and  Sanitation,  pages  315  and  360,  vaccination  should  be 


180  PHYSIOLOGY  AND  HYGIENE. 

compulsory.  The  public  at  large  has  rights  which  far 
exceed  the  ^'personal  liberty"  or  whims  of  a  few  erratic 
individuals,  (b)  Fresh,  pure,  bovine  virus  should  be 
employed;  the  operation  should  be  aseptic  and  efficacious. 
(See  A.  832.) 

SSJj..  State  the  objections  usually  advanced  against  vacci- 
nation as  a  preventive  of  smallpox.     (April,  1897.) 

835.  State  the  objections  usually  made  to  vaccination  by 
those  who  do  not  believe  in  its  efficacy.    {September,  1899.) 

834  and  835.  The  chief  objections  urged  against  vacci- 
nation are  the  following:  (1)  that  vaccination  does  not 
protect  from  smallpox;  (2)  that  it  is  an  infringement  of 
personal  liberty;  (3)  that  smallpox  is  caused  by  filth  and 
not  by  contagion,  and  therefore  vaccination  is  imnecessary ; 
(4)  that  vaccination  is  responsible  for  the  introduction  of 
other  diseases  besides  vaccinia,  notably  syphilis,  tetanus, 
septicaemia,  and  pysemia;  (5)  that  vaccination  is  responsible 
for  an  increased  death  rate. 

XV.  QUARANTINE. 

836.  (a)  Define  the  term  quarantine,  (b)  Mention  the 
principal  quarantinable  diseases  and  (c)  give  the  rules  for 
determining  the  length  of  time  each  should  be  quarantined. 
(January,  1901.) 

837.  (b)  Name  at  least  six  diseases  subject  to  quarantine. 
(May,  1893.) 

838.  (b)  Name  the  diseases  which  require  seaport  quaran- 
tine.    (June,  1893.) 

839.  (b)  What  diseases  require  quarantining  and  (d)  what 
purpose  is  accomplished  by  the  quarantine?  (September, 
1896.) 

8Jf.O.  (b)  What  are  the  principal  quarantinable  diseases? 
(e)  Describe  methods  of  procedure  for  establishing  quarantine 
in  the  case  of  any  one  of  these  diseases.     (September,  1897.) 

8Jf.l .  (d)  What  is  the  object  of  quarantine  and  (h)  what 
diseases  require  it?     (June,  1892.) 


181  PHYSIOLOGY  AND  RYGIENE. 

84^.  (b)  Enumerate  the  diseases  that  should  he  reported 
to  the  health  authorities  as  subject  to  quarantine,  (c)  When 
may  the  quarantine  he  safely  raised  in  each  disease?  {June, 
1901.) 

836  to  842.  (a)  Egbert's  Hygiene  and  Sanitation,  page 
344;  (b)  pages  347,  349;  and  add  ''plague";  (c)  pages  356, 
313  and  314  (''tables of  incubation  period");  (d)  pages 345, 
346;  (e)  pages  346,  352. 

84s.  Give  a  medical  and  hygienic  plan  for  the  inspection 
of  immigrants  who  have  just  arrived  at  a  seaport.  {May, 
1896.) 

843.  Egbert's  Hygiene  and  Sanitation,  pages  347,  353 
and  355. 

XVI.  DISPOSAL  OF  THE  DEAD. 

844.  What  injurious  influences,  if  any,  do  cemeteries  exert 
on  the  health  of  persons  living  in  their  vicinity?    {June,  1895.) 

844.  "It  is  charged  against  earth  burial,  that  the  places 
used  for  the  purpose  are  offensive;  that  the  air  becomes 
poisoned;  that  the  soil  becomes  laden  with  disease  germs 
of  all  descriptions,  which  are  preserved  indefinitely,  and 
that  water  supplies  are  converted  to  dilute  poisons  of  great 
potency;  that  is  to  say,  cemeteries  predispose  to  and  act 
as  direct  causes  of  disease."  (Harrington's  Practical 
Hygiene.) 

845^  Give  the  arguments  in  favor  of  incineration  as  the  hest 
method  of  disposing  of  the  dead.    {May,  1894-) 

846.  State  the  advantages  of  cremation  over  earth  burial. 
{May,  1898.) 

845  and  846.  The  advantages  of  cremation  are:  (1) 
Economy ;  not  only  is  the  actual  process  very  much  cheaper 
than  is  burial,  but  there  is  no  necessity  for  a  community 
to  purchase  large  tracts  of  valuable  land  for  the  dead. 
Under  the  burial  system  the  living  are  being  gradually 
crowded  out  by  the  dead.  (2)  From  a  sanitary  stand- 
I)oint,  all  the  evils  mentioned  above  in  A.  844  are  ob- 


90 


182 


PHYSIOLOGY  AND  HYGIENE. 


viated.    (3)  Body-snatching   and 
would  be  no  longer  possible. 


desecration    of    tombs 


XVII.  VITAL  STATISTICS. 

847.  Give  a  fair  average  death  rate  (a)  in  rural  districts, 
(b)  in  towns  of  from  5000  to  20,000,  and  (c)  in  cities  of  over 
100,000  inhabitants.     (September,  1895.) 

8J^8.  Give  the  ordinary  average  death  rate  in  (a)  rural 
districts,  (c)  cities.     {June,  1897.) 

849.  (d)  State  the  ordinary  death  rate  of  each  of  four  cities 
having  respectively  a  population  of  more  than  50,000.  {May, 
1900.) 

847  to  849.  (a)  Egbert's  Hygiene  and  Sanitation,  page 
430;  (b)  page  430;  (c)  page  430;  (d)  according  to  the  census 
of  1900: 


Population. 

Death  Rate. 

New  York 
Chicago 
Philadelphia 
St.  Louis 

3,437,202 

1,698,575 

1,293,697 

575,238 

20.4 
16.2 
21.2 
17.9 

850.  (a)  What  is  zymotic  death  rate?  (b)  State  causes 
that  make  the  death  rate  high  among  infants  and  young 
children?     {May,  1902.) 

850.  (a)  Egbert's  Hygiene  and  Sanitation,  page  430;  (b) 
page  431. 

851.  What  is  the  expectation  of  life  of  a  professional  man 
in  active  practice  at  the  age  of  forty-five f    {September,  1892.) 

851.  Between  twenty-three  and  twenty-four  years. 


XVIII.  MISCELLANEOUS. 

852.  Give  the  presumptions  of  survivorship  and  the  reasons 
therefor,  in  the  following  from  Casper:    A  is  killed  by  a  thrust 


183  PHYSIOLOGY  AND  HYGIENE. 

of  a  sabre  on  the  head,  B  by  that  of  a  bayonet  in  the  hearty 
and  Cby  a  shot  which  has  torn  open  the  jugular  vein,  {Janu- 
ary, 1896.) 

852.  ''If  we  suppose  three  men  to  be  slain  in  the  same 
tumult,  A  by  a  sabre  cut  on  the  head,  B  by  a  bayonet 
thrust  in  the  heart,  and  C  by  a  gunshot  wound  through  the 
jugular  vein,  no  one  would  hesitate  to  declare  that  in  such 
a  case  B  must  have  died  first,  that  C  must  have  borne  his 
hemorrhage  a  little  longer  ere  he  died,  and  that  A  must 
have  succumbed  to  his  wound  last  of  all."  (Casper's 
Forensic  Medicine.) 

863.  What  is  the  chief  unsanitary  condition  of  sea-going 
vessels?    {January,  1899.) 

853.  Overcrowding;  want  of  ventilation;  presence  of 
bilge-water,  dampness,  and  dirt. 

854'  Admitting  that  baldness  is  more  common  in  men  than 
in  women,  state  some  of  the  reasons  why  it  is  so.  {June, 
1896.) 

854.  ''Premature  loss  of  hair  is  more  common  in  men 
than  in  women,  and  this  fact  is  no  doubt  principally  due 
to  the  large  quantity  of  subcutaneous  fat  in  women.  It 
is  also  owing  to  the  attention  that  woman  devotes  to  this. 
Nature's  ornament,  with  which  she  is  usually  abundantly 
supplied,  that  she  enjoys  greater  immunity  than  man 
from  its  premature  loss.  Women  are  more  apt,  through 
the  fact  of  the  length  and  the  constant  dressing  of 
their  hair,  to  detect  the  first  inroads  of  the  disease,  and 
to  apply  at  once  suitable  remedies.  They  are  able,  through 
the  various  methods  of  dressing  the  hair  now  in  vogue, 
to  conceal  (more  often  the  case  than  generally  supposed) 
any  and  all  evidence  of  thinning  and  baldness."  (Shoe- 
maker, Diseases  of  the  Skin.) 

855.  State  the  powers  and  duties  of  a  board  of  health. 
{September,  1892.) 

855.  A  local  board  of  health  is  expected  to  do  whatever 
is  necessary  and  proper  for  the  preservation  of  life  and 


184  PHYSIOLOGY  AND  HYGIENE, 

health;  to  suppress  nuisances  and  whatever  is  detrimental 
to  the  public  health;  it  may  issue  subpoenas,  compel  the 
attendance  of  witnesses,  administer  oaths  to  witnesses,  and 
compel  them  to  testify,  and  for  such  purposes  it  has  the 
same  powers  as  a  justice  of  the  peace;  it  may  issue 
warrants  for  the  arrest  or  removal  of  such  persons  as 
cannot  otherwise  be  subjected  to  its  orders;  it  may  impose 
penalties  for  failure  to  comply  with  its  regulations.  The 
functions  of  a  State  board  of  health  may  be  classed  as 
follows:  '^(1)  to  promote  the  organization  of  local  and 
municipal  boards ;  (2)  to  obtain  medical  and  vital  statistics ; 
(3)  to  investigate  the  causes  of  undue  sickness  and  mor- 
tality; (4)  the  removal  of  these  causes,  acting  as  far  as 
possible  through  the  local  sanitary  authorities;  (5)  the 
supervision  of  the  hygiene  of  State  institutions;  (6)  the 
supervision  of  quarantine."  {Reference  Handbook  of  the 
Medical  Sciences.) 

856.  Define  (a)  leucomain,  (b)  ptomain.  (January, 
1897.) 

857.  (b)  What  are  ptomains  and  (c)  how  are  they  pro- 
duced?   (June,  1897.) 

858.  (b)  What  are  ptomainsf  (c)  Mention  foodstuffs  the 
ingestion  of  which  occasionally  causes  ptomain  poisoning. 
(April,  1898.) 

859.  (b)  Define  ptomain  and  (c)  give  not  less  than  five 
sources  of  the  origin  of  such  a  product.    (May,  1895.) 

860.  (d)  Describe  the  agency  of  the  ptomains  in  inducing 
disease  and  the  disorders  produced  by  them.     (April,  1893.) 

856  to  860.  (a)  A  leucomain  is  ''an  alkaloid  developed 
in  living  animal  tissues  as  a  result  of  the  normal  vital 
processes."  (Dxisme's  Medical  Dictionary.)  (b) ''A  ptomain 
is  ''a  putrefactive  or  animal  alkaloid;  a  nitrogenous  base 
produced  as  the  result  of  putrefactive  or  morbid  processes 
in  animal  or  vegetable  tissues.  The  term  is  sometimes 
restricted  to  the  non-poisonous  or  very  slightly  poisonous 
members  of  this  group,  the  poisonous  ptomains  being  called 


1S5  PHYSIOLOGY  AND  HYGIENE. 

toxins."  (Duane's  Medical  Dictionary.)  (c)  Tainted 
meat,  pork,  ham,  sausages;  milk,  ice-cream,  cheese;  fish, 
shell-fish,  (d)  They  are  generally  extremely  irritating,  and 
upon  being  absorbed  cause  abdominal  distress  and  griping, 
with  vomiting  and  diarrhoea;  the  pulse  is  small,  weak, 
thready,  and  very  rapid,  or  may  be  abnormally  slow;  the 
countenance  is  sunken  and  pale,  the  extremities  cold  and 
clammy,  and  the  temperature  subnormal;  or  the}^  may 
cause  febrile  disturbance  with  delirium  and  erythematous 
eruptions. 

861.  Give  the  prophylaxis  of  the  filth  diseases.  {November, 
1893.) 

861.  The  prophylaxis  includes  general  cleanliness  of 
person,  clothes,  food,  habits,  and  habitation;  pure  air, 
proper  ventilation,  sufficient  sunlight,  adequate  warmth; 
where  possible  preventive  inoculation;  avoidance  of  those 
suffering  from  disease;  disinfection  and  isolation  to  be 
practised  where  necessary.  See,  too,  under  special  diseases, 
Q.  616  to  622,  631,  635  to  637,  641  to  647,  649,  655,  656, 
660. 

862.  What  conditions  of  ill  health  make  residence  in  high 
altitudes  dangerous?     Whyf     {April,  1896.) 

862.  ''The  contraindications  to  the  high  altitude  resorts 
are:  (1)  advanced  age;  (2)  the  septic  state,  in  which  the 
disease  is  active  and  pyrexia  constant;  (3)  double  cavities 
with  or  without  pyrexia;  (4)  cases  in  which  there  is  great 
irritability  of  the  nervous  system ;  (5)  diseases  of  the  kidney, 
liver,  or  heart;  (6)  diabetes;  (7)  great  loss  of  pulmonary 
tissue;  (8)  emphysema;  (9)  tuberculous  laryngitis.  In 
regard  to  the  latter  disease  there  is  some  difference  of 
opinion.''  {Reference  Handbook  of  the  Medical  Sciences.) 
And  see  Q.  638. 

863.  Mention  the  advantages  which  the  public  would 
realize  from  a  perfected  system  of  public  roads.  {January, 
1893.) 


186  PHYSIOLOGY  AND  HYGIENE, 

863.  Better  means  of  locomotion,  cheaper  provisions, 
easier  access  to  schools,  etc.;  greater  health  owing  to 
drainage.  If  the  roads  are  kept  clean,  the  health  of  those 
whose  homes  abut  the  road,  and  the  children  who  make 
a  playground  of  the  public  streets,  will  be  improved. 

864-  Define  the  word  nuisance  in  a  broad,  hygienic  sense. 
{September,  1894.) 

864.  A  nuisance  is  anything  that  injuriously  affects  the 
health  or  comfort  of  any  members  of  a  community. 

865.  Name  some  of  the  nuisances  dangerous  to  health. 
(July,  1893.) 

865.  Carpet  beating  and  cleaning,  sandblasting  of  glass, 
keeping  of  certain  live  animals  near  human  habitations, 
storage  of  animal  matters;  killing  of  animals,  fat  render- 
ing, lard  refining,  bone  and  blood  boiling,  tanning,  gut 
cleaning.     And  see  Q.  748  and  749. 

866.  Give  (a)  the  symptoms  and  (b)  phenomena  of  auto- 
infection.     {January,  1898.) 

866.  (a)  "  The  symptoms  of  autoinfection  are  headache, 
vertigo,  insomnia,  lassitude,  neurasthenia,  migraine,  and 
cerebral  congeston.  Sometimes  fever  and  a  multiform 
cutaneous  eruption  are  present."  (b)  "  Autoinfection  is 
infection  caused  by  certain  processes  that  originate  and 
develop  in  the  organism  itself.  It  usually  refers  to  the 
absorption  of  poisonous  substances  produced  in  the  gastro- 
intestinal tract.  These  substances  occur  in  normal  digestion 
as  well  as  in  abnormal  digestion,  and,  normally,  they 
should  be  eliminated.  The  causes,  therefore,  are  diseased 
conditions  of  the  digestive  tract,  allowing  these  substances 
to  be  produced  in  excess,  and  disorders  of  the  organs 
whose  function  is  to  eliminate  such  poisons."  (Gould's 
Pocket  Cyclopedia  of  Medicine  and  Surgery.) 

867.  A  law  to  prevent  owners  of  land,  in  the  narrow  streets 
of  New  York  City  from  erecting  buildings  more  than  twelve 
stories  in  height  is  being  agitated.  Give  sanitary  and  hygienic 
reasons  (a)  for  or  (b)  against.    {June,  1896.) 


187  PHYSIOLOGY  AND  HYGIENE. 

867.  (a)  Reasons  in  favor  of  high  buildings :  The  inhabi- 
tants of  the  upper  floors  would  have  good  light,  sunshine, 
and  pure  air;  would  not  be  disturbed  by  street  noises 
and  dust;  would  not  be  injured  by  soil-air  and  water, 
(b)  Against:  The  inhabitants  of  the  neighborhood  are  de- 
prived of  sunlight  and  ventilation.  In  case  of  fire  there  is 
more  difficulty  in  extinguishing  it,  and  the  occupants  of 
the  upper  floors  may  find  it  more  difficult  to  escape. 

868.  At  what  distance  for  sanitary  reasons  should  shade 
trees  he  placed  in  city  or  village  streets?    (January,  1894-) 

868.  The  exact  distance  will  depend  on  the  kind  of 
trees  and  the  pruning  that  they  receive;  in  any  case  the 
distance  should  be  such  that  the  trees  do  not  touch  the 
houses,  and  also  do  not  interlace  with  each  other  except 
at  a  distance  of  at  least  thirty  or  forty  feet  above  the 
ground. 

869.  State  the  effect  of  vegetation  on  climate.  (January, 
1902.) 

870.  How  do  forests  benefit  public  health?  (January, 
1895.) 

869  and  870.  ''In  cold  climates  trees  and  shrubs  obstruct 
the  passage  of  the  sun's  rays  to  the  soil,  which  is  therefore 
liable  to  be  cold  and  moist ;  but  in  hot  climates  the  evapora- 
tion of  water  from  the  leaves  tends  to  dry  the  soil,  while 
the  temperature  of  the  air  is  lowered,  and  the  ground  is 
sheltered  from  the  direct  rays  of  the  sun  and  kept  cool. 
Thus,  the  heat  of  summer  is  lowered  and  the  cold  of  winter 
lessened  by  the  presence  of  trees,  and,  having  a  lower 
temperature  than  the  neighboring  earth's  surface,  high 

forests  increase  the  rainfall Probably  in  all 

climates  a  due  admixture  of  herbage,  shrubs,  and  trees, 
without  dense  undergrowth,  but  admitting  the  passage  of 
free  currents  of  air  in  every  direction,  is  the  most  conducive 
to  health.  Large  tracts  of  country  destitute  of  trees  and 
vegetation  are  in  hot  climates  unbearably  warm  and  dry, 
and  in  cold  climates  are  exposed  to  every  chilling  wind 


188  PHYSIOLOGY  AND  HYGIENE. 

and  to  every  extreme  of  temperature,  according  to  the 
season  of  the  year.  In  such  districts,  too,  rainfall  is  often 
absent  or  very  slight  in  amount,  the  attractive  influence 
exerted  by  trees  and  vegetation  generally  upon  water- 
charged  clouds  being  wanting.'^  (Parke's  Practical  Hy- 
giene.) 


APPENDIX. 


Questions  asked  January,  1903. 

871.  (a)  Describe  by  diagram  or  otherwise  the  human  red 
blood  corpuscle,  and  (b)  give  its  chemical  composition  and 
(c)  biological  changes. 

871.  (a)  See  Q.'83  (b);  (b)  see  A.  to  947  (a);  (c)  Collins 
and  Rockwell's  Physiology,  pages  34  to  38. 

872.  What  are  the  enzymes  of  the  pancreatic  juice,  and 
what  office  does  each  one  perform  in  the  process  of  digestion? 

872.  See  Q.  235. 

873.  Give  the  physiological  changes  that  occur  at  puberty 
in  (a)  the  male,  (b)  the  female. 

873.  (a)  The  voice  changes,  becoming  deeper;  hair 
appears  on  face,  pubes,  and  other  parts  of  the  body ;  sexual 
feelings  are  experienced;  the  genitals  enlarge  and  secrete 
fluids,  and  spermatozoa  are  produced,  (b)  Cdllins  and 
Rockwell's  Physiology,  page  274. 

874'  Describe  the  functions  of  the  liver. 

874.  See  Q.  242  to  244. 

875.  (a)  What  is  the  endocardium?  (b)  How  is  the  endo- 
cardium nourished? 

875.  (a)  The  endocardium  is  a  thin,  smooth,  transparent 
membrane,  lining  the  internal  surface  of  the  heart,  and  is 
continuous  with  the  inner  coats  of  the  bloodvessels,  (b) 
The  endocardium  is  nourished  by  its  own  capillary  supply. 

876.  Give  the  functions  of  the  trigeminal  nerve. 
876.  See  Q.  494. 

( 189 ) 


23 


190  APPENDIX, 

877.  (a)  Describe  the  function  of  the  kidneys,  (b)  Do 
both  kidneys  act  constantly?    Explain. 

877.  (a)  See  Q.  367  and  368.  (b)  Collins  and  Rockwell's 
Physiology,  page  133. 

878.  What  does  each  of  the  following  contribute  to  vital 
activity:    (a)  proteids,  (b)  fats,  (c)  carbohydrates? 

878.  Egbert's  Hgyiene  and  Sanitation,  pages  215  to  217. 

879.  Give  the  particular  function  of  each  heart  valve. 

879.  Collins  and  Rockwell's  Physiology,  page  53. 

880.  (a)  What  constitutes  the  respiratory  apparatus?  (b) 
Describe  in  detail  both  the  inspiratory  and  the  expiratory 
movements  of  respiration  and  (c)  the  movements  of  the  glottis 
in  connection  with  each. 

880.  (a)  The  respiratory  apparatus  consists  of  the  nose, 
nasopharynx,  oropharynx,  larynx,  trachea,  bronchi,  lungs, 
and  thorax,  (b)  See  Q.  158  to "^167  (b).  (c)  The  vocal  cords 
separate  during  inspiration,  and  approach  each  other 
during  expiration. 

881.  What  evidences  of  contamination  of  drinking-water 
may  be  obtained  by  chemical  analysis? 

881.  Egbert's  Hygiene  and  Sanitation,  pages  209  to  213. 

882.  How  should  disinfectants  be  applied  to  (a)  the  hands 
of  the  operator  in  preparation  for  surgical  work,  (b)  bed  linen 
and  clothing,  (c)  feces  and  urine? 

882.  (a)  See  Q.  815;  (b)  see  Q.  821;  (c)  see  Q.  825. 

88S.  Describe  the  procedure  of  (a)  establishing  a  quarantine 
in  contagious  diseases,  (b)  lifting  a  quarantine  in  contagious 
diseases. 

883.  (a)  See  Q.  840  (e);  (b)  see  Q.  836  to  842  (c). 

884.  Describe  the  best  method  of  constructing  a  house  drain. 

884.  Egbert's  Hygiene  and  Sanitation,  pages  368  et  seq. 

885.  Mention  and  describe  the  diseases  of  animals  that  are 
communicable  to  man,  and  state  the  means  that  should  be 
employed  for  the  prevention  of  these  diseases  in  man. 


191  APPENDIX. 

885.  Tuberculosis,  actinomycosis,  diphtheria,  vaccinia, 
septicaemia,  hydrophobia,  anthrax,  glanders,  bubonic 
plague,  intestinal  parasites,  trichiniasis,  hydatid  disease, 
ringworm;  and  see  Q.  670  (a);  for  description  and  prophy- 
laxis, see  Thompson's  Practical  Medicine. 


Questions  asked  May,  1903. 

886.  Where  in  the  body  may  the  following  epithelial  cells  he 
found:  (a)  squamous,  (b)  ciliated,  (c)  polyhedral,  (d) 
columnar,  (e)  transitional? 

886.  (a)  In  the  superficial  layer  of  the  skin  and  its 
extensions,  the  alveoli  of  the  lungs,  glomerulus,  and  Henle's 
tube  in  the  kidneys,  ureter,  bladder,  vagina,  oesophagus, 
(b)  in  the  Eustachian  tube,  tympanum,  respiratory  part 
of  nasal  fossae,  trachea,  bronchi,  larynx.  Fallopian  tube, 
ventricles  of  the  brain,  efferent  ducts  of  the  testis;  (c)  in 
the  salivary  glands;  (d)  in  the  stomach,  intestines,  and 
ducts  of  most  glands;  (e)  in  the  pelvis  of  the  kidney, 
ureter,  and  bladder. 

887.  Describe  (a)  the  development  and  (b)  functions  of 
teeth. 

887.  (a)  See  Q.  52;  (b)  see  Q.  51  (c). 

888.  (a)  Describe  the  systemic  blood  circulation,  (b)  State 
in  detail  the  changes  that  take  place  in  the  character  of  the 
systemic  blood. 

888.  (a)  See  Q.  105  to  111  (b);  (b)  see  Q.  95  to  97  (b). 

889.  Mention  the  forces  at  work  in  the  absorption  of 
digested  food. 

889.  See  Q.  289  to  291. 

890.  State  the  functions  of  the  medulla  oblongata. 
890.  Collins  and  Rockwell's  Physiology,  page  188. 


192  APPENDIX. 

891.  Describe  the  normal  heart  sounds  and  state  where 
they  are  best  heard. 

891.  See  Q.  126  to  128. 

892.  Give  the  perversion  of  function  that  may  cause  (a) 
vomiting,  (b)  hiccup. 

892.  (a)  Collins  and  Rockwell's  Physiology,  page  101; 
(b)  page  89. 

893.  Describe  the  function  of  the  kidney. 

893.  See  Q.  367  and  368. 

894.  What  would  be  the  effect  of  an  exclusive  diet  of  (1) 
nitrogenous  food,  (2)  fats  and  carbohydrates?    Explain. 

894.  Egbert's  Hygiene  and  Sanitation,  pages  228  to  237, 
and  215. 

895.  (a)  In  what  part  of  the  body  is  the  sense  of  touch 
most  delicate?  (b)  Describe  the  nervous  mechanism  on  which 
the  sense  of  touch  depends. 

895.  (a)  Collins  and  Rockwell's  Physiology,  page  224; 
(b)  page  222. 

896.  Give  the  rationale  of  the  use  of  the  various  antitoxins. 

896.  Egbert's  Hygiene  and  Sanitation,  pages  58  et  seq. 

897.  (a)  Mention  some  pathogenic  bacilli  found  in  drink- 
ing-water, and  (b)  state  what  means  should  be  employed  to 
destroy  their  infectiousness,  (c)  How  may  such  impure  water 
contaminate  a  milk  supply? 

897.  (a)  Egbert's  Hygiene  and  Sanitation,  pages  167  to 
169;  (b)  pages  176  et  seq.;  note  particularly  page  200;  (c) 
by  being  used  to  dilute  the  milk  or  to  wash  the  containers. 

898.  Mention  some  of  the  diseases  incidental  to  school  life. 

898.  See  Q.  779  to  782  (a). 

899.  Mention  fiye  occupations  prejudicial  to  health. 
Explain. 

899.  See  Q.  743  to  749. 


193  APPENDIX. 

900.  (a)  Give  the  nervous  and  muscular  mechanism  o] 
respiration,     (b)  Where  is  the  respiratory  centre  located? 
900.  (a)  See  Q.  175;  (b)  see  Q.  204. 


Questions  asked  June,  1903. 

901.  Mention  the  waste  products  of  metabolism  and  state 
how  they  escape  from  the  body. 

901.  See  Q.  596  (b). 

902.  Give  the  complete  physiology  of  (a)  stomach  digestion, 
(b)  small  intestine  digestion. 

902.  (a)  Collins  and  Rockwell's  Physiology,  pages  97  to 
100;  (b)  page  101. 

903.  Describe  the  colorless  corpuscles  of  the  blood  as  to  (a) 
development,  (b)  size,  (c)  form,  (d)  number,  (e)  function. 

903.  (a)  Collins  and  Rockwell's  Physiology,  page  39; 
(b)  page  38;  (c)  pages  38  and  39;  (d)  page  32;  (e)  page  40. 

904.  (a)  What  organs  and  forces  are  concerned  in  blood 
circulation?  (b)  Trace  the  complete  course  of  the  circidation, 
beginning  at  the  right  ventricle. 

904.  (a)  Collins  and  Rockwell's  Physiology,  page  48; 
(b)  page  49.  ' 

905.  Describe  spermatozoa  microscopically  and  physio- 
logically. 

905.  See  Q.  585. 

906.  Mention  the  varieties  of  epithelium.  State  the  function 
of  epithelium. 

906.  See  Q.  24. 

907.  Give  the  origin,  distribution,  and  function  of  the 
olfactory  nerves. 

907.  Collins  and  Rockwell's  Physiology,  pages  230  to 
232. 


194  APPENDIX. 

908.  Mention  the  conditions  that  control  body  temperature. 

908.  See  Q.  443  to  445. 

909.  (a)  How  is  uric  acid  developed  in  the  human  system? 

(b)  What  class  of  foods  increases  the  development  of  uric  acid? 

909.  (a)  ''Uric  acid  represents  one  of  the  metabolic 
products  of  the  nucleic  acids.  The  latter  are  present  in  the 
diet  in  variable  quantities  and  occur  in  nature  in  the  so- 
called  nucleoproteids  (nucleates),  which  are  salts  of  proteids 
with  nucleic  acid.  On  decomposition  the  nucleic  acids 
yield  one  or  more  of  the  purin  derivatives,  usually  adenin  or 
guanin,  which  undergo  oxidation  in  the  body.  Uric  acid 
is  an  intermediate  stage  in  the  complete  decomposition; 
when  introduced  as  such  into  the  body  it  is  largely  burned 
up.  Experiments  by  Mendel  and  others  make  it  probable 
that  the  liver  is  the  seat  of  the  oxidations  referred  to. 
There  is  no  evidence  that  the  spleen  is  involved,  as  has 
been  assumed.  While  the  possibility  of  a  synthetic  for- 
mation of  uric  acid  has  not  been  absolutely  excluded,  it 
cannot  play  any  important  role  under  ordinary  conditions. 
In  the  absence  of  purin  compounds  in  the  diet,  the  uric 
acid  output  in  man  does  not  ordinarily  exceed  300  mgm. 
per  day.  Uric  acid  bears  no  direct  relation  to  urea  in 
metabolism,  although  the  latter  may  be  formed  from  it." 
(Reference  Handbook  of  the  Medical  Sciences.)  (b)  Fresh 
meats  chiefly,  particularly  flesh  of  growing  animals;  also 
tea,  coffee,  and  cocoa. 

910.  What  is  (a)  reserve  air,  (b)  residual  air?  (c)  What 
is  meant  by  the  vital  capacity  of  the  lungs? 

910.  (a)  See  Q.  163  to  165  (e) ;  (b)  see  Q.  164  to  166  (h) ; 

(c)  Collins  and  RockwelFs  Physiology,  pages  83  and  82. 

911.  Describe  (a)  hard  water,  (b)  soft  water,  (c)  How  may 
hard  water  be  converted  into  soft  water  for  drinking  purposes? 

911.  (a)  See  Q.  695  (a) ;  (b)  see  Q.  695  (b) ;  (c)  by  boiling, 
or  by  the  addition  of  lime  and  caustic  soda  or  sodium 
carbonate. 


195  APPENDIX. 

912.  State  the  impurities  that  may  exist  in  (a)  natural  ice, 
(b)  artificial  ice. 

912.  (a)  See  under  Water  Impurities,  Egbert's  Hygiene 
and  Sanitation,  pages  152,  167  and  176;  (b)  see  (a);  if  the 
water  is  first  boiled,  bacteria  are  killed;  if  distilled,  ammonia 
is  the  only  impurity  present;  and  see  Q.  720  and  721. 

918.  What  are  (a)  the  physical  and  (b)  the  chemical 
properties  of  sweat?  (c)  What  is  the  influence  of  the  nerves 
on  the  excretion  of  sweat? 

913.  (a)  Collins  and  Rockwell's  Physiology,  pages  124 
and  125;  (b)  see  Q.  391;  (c)  see  Q.  393. 

914'  (a)  What  conditions  of  soil  and  climate  are  most 
favorable  for  the  residence  and  treatment  of  tuberculous 
patients?  (b)  Mention  three  localities  in  the  United  States 
where  these  conditions  may  be  found. 

914.  (a)  See  Q.  640;  (b)  Colorado,  New  Mexico,  Adiron- 
dacks. 

915.  (a)  Mention  the  diseases  that  may  be  transmitted  by 
the  ingestion  of  contaminated  meat  and  fish,  (b)  What  means 
should  be  adopted  to  prevent  such  diseases? 

915.  (a)  Ptomain  poisoning,  dysentery,  tuberculosis, 
tape-worms,  round-worm,  trichiniasis,  hydatid  disease;  (b) 
see  Q.  885. 


Questions  asked  September,  1903. 

916.  Describe  cell  growth.     Illustrate. 

916.  See  Q.  14  and  15. 

917.  Describe  in  detail  each  step  in  the  digestion  of  a  meal 
containing  proteids,  carbohydrates,  fats,  water,  and  inorganic 
salts. 

917.  See  Q.  281  to  288. 

918.  Compare  (a)  lymph  and  chyle,  (b)  blood  and  lymph. 
(c)  What  is  chyme? 


196  APPENDIX. 

918.  (a)  See  Q.  317  to  319;  (b)  Collins  and  RockwelFs 
Physiology,  pages  46  and  47 ;  (c)  see  Q.  320  (a) . 

919,  (a)  Describe  the  fetal  circulation,  (b)  Mention  the 
changes  that  take  "place  in  the  circulation  of  the  blood  imme- 
diately after  birth. 

919.  (a)  See  Q.  117  and  118;  (b)  Collins  and  Rockwell's 
Physiology,  page  296. 

920.  What  would  be  the  effect  of  a  division  of  the  third 
cranial  nerve? 

920.  See  Q.  492  (d). 

921.  What  theories  have  been  advanced  regarding  the 
function  of  (a)  the  spleen,  (b)  the  suprarenal  capsule,  (c)  the 
thyroid  gland? 

921.  (a)  See  Q.  434.  (b)  '^The  removal  of  the  supra- 
renal capsules  is  more  quickly  fatal  than  the  removal  of 
the  thyroids,  death  occurring  in  a  few  hours  or  a  few  days. 
The  symptoms  are  muscular  weakness,  loss  of  vascular 
tone,  and  great  prostration,  resembling  those  of  Addison's 
disease,  which  involves  lesions  of  the  adrenals.  The  glands 
may  normally  be  supposed  to  remove  toxic  substances 
from  the  body,  which  are  formed  chiefly  in  the  muscles." 
(Guenther's  Physiology.)  (c)  ''It  appears  that  the  thyroids 
and  accessory  thyroids,  on  the  one  hand,  differ  from  the 
parathyroids,  on  the  other,  in  that  removal  of  the  first 
causes  slow  trophic  disturbances,  while  removal  of  the 
last  results  in  acute  disturbances  and  quick  death.  These 
glands  may  be  regarded  as  functionating  in  two  ways. 
They  may  either  antagonize  toxic  substances  that  are 
foimd  in  the  blood,  or  may  produce  a  secretion  which  is 
necessary  to  the  metabolism  of  the  body  in  general,  and 
particularly  of  the  central  nervous  system."  (Guenther's 
Physiology.) 

922.  (a)  State  the  physiological  cause  of  fatigue  of  muscles. 
(b)  Describe  rigor  mortis. 

922.  (a)  See  Q.  402;  (b)  see  Q.  405  to  409  (a). 


197  APPENDIX. 

923.  (a)  What  is  understood  hy  accommodation  of  the  eye? 
(b)  Give  the  mechanism  of  accommodation  of  the  eye. 

923.  (a)  Collins  and  RockwelFs  Physiology,  page  250; 

(b)  see  Q.  558  (a). 

924.  Beginning  at  the  'pelvis  of  the  kidney,  describe  in 
detail  the  nervous  and  muscular  mechanism  by  which  the 
urine  is  discharged  from  the  body. 

924.  Collins  and  Rockwell's  Physiology,  pages  133  and 
129. 

926.  Give  the  cause  of  (a)  aphasia,  (b)  asphyxia. 

925.  (a)  See  Q.  602  (b) ;  (b)  see  Q.  195  to  203  (b)  and 
(c);  and  602  (c). 

926.  (a)  What  evidences  of  contamination  of  drinking- 
water  may  be  obtained  by  bacteriological  analysis?  (b) 
Compare  the  value  of  chemical  analysis  with  that  of  bacterio- 
logical analysis. 

926.  (a)  Egbert's  Hygiene  and  Sanitation,  pages  167, 
207  and  213.  (b)  Chemical  analysis  is  of  value  only  as 
indicating  the  degree  of  contamination  and  the  possible 
source.    It  does  not  indicate  the  degree  of  danger  to  health. 

927.  State  the  relative  value  of  the  following  methods  of 
sewage  disposal:  (a)  seioage  irrigation,  (b)  sewage  filtration, 

(c)  the  pail  system,  (d)  chemical  treatment. 

927.  (1)  Sewage  irrigation;  (2)  the  pail  system;  (3) 
sewage  filtration;  (4)  chemical  treatment.  See  Q.  804  to 
806. 

928.  (a)  Discuss  the  immunizing  power  of  vaccination. 
(b)  State  the  possible  dangers  of  vaccination. 

928.  (a)  Egbert's  Hygiene  and  Sanitation,  pages  360  to 
362;  (b)  see  Q.  834  and  835  (4). 

929.  (a)  How  does  proper  physical  exercise  promote  health 
and  strength?  (b)  What  is  the  effect  of  continued  excessive 
exercise? 

929.  (a)  Egbert's  Hygiene  and  Sanitation,  pages  278 
et  seq.;  (b)  cardiac  hypertrophy  and  dilatation,  valvular 


2i 


198  APPENDIX. 

insufficiency  with  its  results,   arteriosclerosis,   aneurysm^ 
chronic  interstitial  nephritis,  etc. ;  and  see  Q.  738  and  739. 

930.  Give  a  complete  method  of  room  disinfection  after  the 
removal  of  an  infected  patient. 
930.  See  Q.  816  and  817. 


Questions  asked  January,  1904. 

931.  Enumerate  the  ultimate  chemical  elements  that  are 
physiologically  present  in  the  tissues  of  the  human  body. 

931.  Collins  and  Rockwell's  Physiology,  pages  24  and  26. 

932.  Mention  and  illustrate  the  varieties  of  epithelium  and 
indicate  their  functions. 

932.  See  Q.  24  to  29. 

933.  Give  in  regard  to  hone  (a)  structure,  (b)  method  of 
nourishment,  (c)  physical  and  chemical  properties,  (d) 
functions. 

933.  (a)  ' '  A  thin,  transverse  section  of  a  decalcified  bone, 
when  examined  microscopically,  reveals  a  number  of  small, 
round,  or  oval  openings,  which  represent  transverse  sections 
of  canals  which  run  through  the  bone,  for  the  most  part 
in  a  longitudinal  direction,  though  frequently  anastomosing 
with  one  another.  These  so-called  Haversian  canals  in  the 
living  state  contain  bloodvessels  and  lymphatics.  Around 
each  Haversian  canal  is  a  series  of  concentric  laminae, 
composed  of  white  fibres.  Between  every  two  laminae  are 
found  small  cavities  (lacunae),  from  which  radiate  in  all 
directions  small  canals  (canaliculi),  which  communicate 
freely  with  one  another.  The  Haversian  canals,  with  their 
associated  lacunae  and  canaliculi,  form  a  system  of  inter- 
communicating passages,  through  which  lymph  circulates 
destined  for  the  nourishment  of  bone.  Each  lacuna  con- 
tains the  bone  corpuscle,  which  bears  a  close  resemblance 
to  the   usual   branched    connective-tissue   corpuscle,  and 


199  .         APPENDIX. 

whose  function  appears  to  be  the  maintenance  of  the 
nutrition  of  the  bone.  The  surface  of  every  bone  in  the 
recent  state  is  invested  with  a  fibrous  membrane,  the  peri- 
osteum, except  where  it  is  covered  with  cartilage.  The 
inner  surface  of  this  membrane  is  loose  in  texture,  and 
supports  a  fine  capillary  plexus  of  bloodvessels  and  numer- 
ous protoplasmic  cells — the  osteoblasts.  As  this  layer  is 
directly  concerned  in  the  formation  of  bone,  it  is  spoken 
of  as  the  osteogenetic  layer.''  (Brubaker's  Physiology.) 
(b)  See  Q.  44  to  46  (a),  (c)  ''Bone  is  one  of  the  hardest 
structures  of  the  animal  body;  it  possesses  also  a  certain 
degree  of  toughness  and  elasticity.  Its  color,  in  a  fresh 
state,  is  of  a  pinkish-white  externally  and  deep  red  within. 
On  examining  a  section  of  any  bone,  it  is  seen  to  be  com- 
posed of  two  kinds  of  tissue,  one  of  which  is  dense  and 
■compact  in  texture,  like  ivory;  the  other  consists  of  slender 
fibres  and  lamellse,  which  join  to  form  a  reticular  structure; 
this,  from  its  resemblance  to  lattice-work,  is  called  cancel- 
lous. The  compact  tissue  is  always  placed  on  the  exterior 
of  the  bone ;  the  cancellous  is  always  internal.  The  relative 
quantity  of  these  two  kinds  of  tissue  varies  in  different 
bones,  and  in  different  parts  of  the  same  bone,  as  strength 
or  lightness  is  requisite.  Close  examination  of  the  compact 
tissue  shows  it  to  be  extremely  porous,  so  that  the  differ- 
ence in  structure  between  it  and  the  cancellous  tissue 
depends  merely  upon  the  different  amount  of  solid  matter, 
and  the  size  and  number  of  spaces  in  each;  the  cavities 
being  small  in  the  compact  tissue  and  the  solid  matter 
between  them  abundant,  while  in  the  cancellous  tissue  the 
spaces  are  large  and  the  solid  matter  in  smaller  quantity.'' 
(Gray's  Anatomy.)    The  chemical  composition  is  given  as : 

Gelatin  and  bloodvessels 33  per  cent. 

Phosphate  of  calcium 57       " 

Carbonate  of  calcium 8       " 

Fluoride  of  calcium 1       " 

Phosphate  of  magnesium 1       " 

100  per  cent. 
(Dunglison's  Medical  Dictionary.) 


200  APPENDIX. 

(d)  To  act  as  the  framework  of  the  body  and  to  give  it 
stabiUty;  to  protect  organs  and  viscera;  to  assist  in  the 
formation  of  joints;  to  furnish  points  of  attachment  for 
muscles,  and  to  serve  as  levers. 

934.  Mention  the  digestive  glands  and  state  the  'particular 
function  of  each. 

934.  See  A.  231  to  239  (e);  and  table  of  secretions  in 
Collins  and  Rockwell's  Physiology,  page  136. 

935.  Describe  (a)  serous  membranes,  (b)  synovial  mem- 
branes, (c)  State  the  functions  of  each,  (d)  Enumerate  the 
serous  membranes  of  the  body. 

935.  (a)  See  Q.  411;  (b)  see  Q.  411;  (c)  see  Q.  412;  (d) 
the  peritoneum,  the  pleura,  the  pericardium,  and  the 
tunica  vaginalis  of  the  testis. 

936.  Define  and  describe  (a)  lymphatics,  (b)  chyme,  (c) 
chyle. 

936.  (a)  See  Q.  306  and  307;  (b)  see  Q.  320  (a);  (c)  see 
Q.  320  (b). 

937.  (a)  Where  and  how  is  urea  formed  in  the  body?  (b) 
In  what  quantity  is  urea  excreted  by  an  adult  in  21^  hours? 

937.  (a)  See  Q.  382  to  384;  (b)  see  Q.  380  (f). 

938.  How  is  the  heat  of  the  body  (a)  produced,  (b)  dissi- 
pated?   (c)  Mention  the  functions  of  the  skin. 

938.  (a)  See  Q.  439  to  445  (b);  (b)  Collins  and  Rock- 
well's Physiology,  page  141;  (c)  see  Q.  385  to  387. 

939.  State  the  effect  on  respiration  of  section  of  (a)  one 
phrenic  nerve,  (b)  both  phrenic  nerves. 

939.  (a)  Slight  impairment  of  diaphragmatic  action ;  (b) 
paralysis  of  the  diaphragm,  greatly  impairing  respiration, 
and  causing  dyspnoea. 

94.0.  Mention  the  forces  that  produce  and  maintain  the 
circulation  of  the  blood  in  the  arteries,  capillaries,  and  veins. 

940.  Collins  and  Rockwell's  Physiology,  pages  56,  54 
and  55. 


201  APPENDIX. 

941 '  (a)  Give  the  ordinary  composition  of  atmospheric  air. 
(b)  State  the  permissible  limit  of  CO^  in  air. 

941.  (a)  Egbert's  Hygiene  and  Sanitation,  page  68;  (b) 
pages  71  and  75. 

94-2.  Describe  the  hygienic  construction  of  a  bedchamber  for 
two  adult  persons,  touching  on  size,  shape,  air  inlets  and 
outlets,  heating  and  lighting.    Give  reasons. 

942.  The  room  should  be  not  less  than  about  twenty 
feet  long  by  ten  feet  wide,  and  not  less  than  ten  feet  high. 
For  air  inlets  and  outlets,  see  Egbert's  Hygiene  and 
Sanitation,  pages  121  to  123.  Heating  should  be,  preferably, 
by  hot-air  furnace;  and  lighting  by  incandescent  light  or 
Welsbach  light. 

94s.  What  appliances  are  commonly  employed  for  the 
heating  of  houses?  What  is  their  comparative  value f  Give 
reasons  for  conclusion. 

943.  See  Q.  766  to  768. 

944-  State  in  detail  the  means  that  may  be  employed  to 
prevent  the  spread  of  epidemics  of  (a)  Asiatic  cholera,  (b) 
bubonic  plague,  (c)  smallpox. 

944.  (a)  Egbert's  Hygiene  and  Sanitation,  page  353 
et  seq.;  and  see  Q.  659;  (b)  see  Q.  660  (b) ;  (c)  see  Q.  655  (a). 

945.  Give  an  analysis  {parts  per  10,000)  of  a  proper 
drinking-water.  State  parts  per  10,000  of  the  following 
which  render  a  water  non-potable:  free  ammonia,  albuminoid 
ammonia,  nitrogen  as  nitrates,  nitrogen  as  nitrites,  chlorin, 
volatile  residue,  fixed  residue. 

945.  The  following  table  is  compiled  from  figures  given 
in  Harrington's  Practical  Hygiene;  the  figures  given  in 
column  A  denote  a  ^' water  of  undoubted  purity;"  those 
given  in  colunm  B  are  '' sufficient  for  unqualified  condem- 
nation." The  figures  have  been  reduced  to  parts  in  10,000, 
in  conformity  with  the  question: 


202 

APPENDIX. 

A 

B 

Free  ammonia 
Albuminoid  ammonia 
Nitrogen  as  nitrates 
Nitrogen  as  nitrites 
Chlorin 

Volatile  residue 
Fixed  residue 

0.00002 
0.00018 
0.00240 
0.00000 
0.00700 
0.12500 
0.16000 

0.04750 
0.00585 
0.46000 
0.00540 
0.42700 
1.11000 
2.33000 

Questions  asked  May,  1904. 


9Ji.6.  (a)  What  is  the  purpose  of  water  in  the  organism? 
(b)  What  proportion  of  the  body  weight  is  water?  (c)  State 
the  principal  sources  from  which  this  water  is  derived,  and 
(d)  mention  the  avenues  through  which  it  is  discharged  from 
the  body. 

946.  (a)  ''Water  is  the  most  important  of  the  inorganic 
constituents,  as  it  is  indispensable  to  life.  It  is  present  in 
air  the  tissues  and  fluids  without  exception.  Much  of  the 
water  exists  in  a  free  condition,  and  forms  the  chief  part 
of  the  fluids,  giving  to  them  their  characteristic  degree  of 
fluidity.  Possessing  the  capability  of  holding  in  solution 
a  large  number  of  inorganic  as  well  as  some  organic  com- 
pounds, and  being  at  the  same  time  diffusible,  it  renders 
an  interchange  of  materials  between  all  portions  of  the 
body  possible.  It  aids  in  the  absorption  of  new  material 
into  the  blood  and  tissues,  and  at  the  same  time  it  transfers 
waste  products  from  the  tissues  to  the  blood,  from  which 
they  are  finally  eliminated,  along  with  the  water  in  which 
they  are  dissolved.  A  portion  of  the  water  is  chemically 
combined  with  other  tissue  constituents,  and  gives  to  the 
tissues  their  characteristic  physical  properties.    The  con- 


203  APPENDIX. 

sistency,  elasticity,  and  pliability  are,  to  a  large  extent, 
conditioned  by  the  amount  of  water  they  contain." 
(Brubaker's  Physiology.)  (b)  About  two-thirds,  or  66  per 
cent,  (c)  The  food  and  water  ingested,  and  it  is  also 
formed  in  the  body,  (d)  By  the  kidneys  as  urine,  by  the 
skin  as  perspiration,  by  the  limgs  as  watery  vapor,  and  by 
the  intestines  in  the  feces. 

947.  (a)  Give  the  composition  of  blood,  (b)  Under  what 
conditions  does  blood  clot  in  the  vessels? 

947.  (a)  ''Analysis  of  the  blood  proves  it  to  be  composed 
of  775  to  800  parts  of  water  and  200  to  225  parts  of  solids. 
The  solids  are  192  to  217  parts  of  organic  and  7  to  8  parts 
of  inorganic  matter.  The  organic  matter  is  composed  of 
haemoglobin,  of  proteids,  fats,  and  traces  of  sugar,  while 
the  inorganic  matter  is  composed  of  NaCl,  KCl,  NaHCOg, 
Na^HPO,,  CaHPO,,  CaSO,,  MgCl^,  etc.  The  best  idea  of  the 
chemical  composition  of  the  blood  as  a  whole  may  be 
obtained  by  first  separating  the  blood  into  plasma  and 
corpuscles  by  centrifugation,  and  then  analyzing  each 
separately.  Human  blood  so  treated  would  give  approxi- 
mately the  results  recorded  in  the  following  table,  which 
is  the  result  of  an  analysis  reported  by  Halliburton: 


204 


APPENDIX. 


Plasma 

Take  100 
parts. 


Per  cent. 
Water 90.29 


Solids 
9.71?^ 


Organic 

8.86  5i 


Inorganic 

0.85^ 


Proteids 


Serum  albumin 
Serum  globulin 
Fibrin  .... 


Extractives :  fats,  etc. 

f  NaCl 
Soluble    J  KCl 
salts        1  NaHCOg 
L  Na,HP04 
Insoluble  /  CaHP04 
salts       t  CaS04 


7.9 
0.4 

0.56 


0.85 


100. 00 


Cor- 
puscles 

Take  100 
parts. 


Water 68.80 


f   Organic 
30.4^ 


Solids 
31.2?^ 


f  Proteids 
I       29. 79?^ 


Fats 


Hsemo-  (Hsema- 
globin  •{     tin     , 
27       (Globulin 
Globulin 


m      ) 


27.36 
2.43 


Lecithin      \ 
Cholesterin  j 


0.61 


f  KCl 
Inorganic  '   g^g 
0-8?^       i   Ca^HPU 


0.80 


L    Mg3(P04^2   J 

Fe  [See  Hsematin.] 


100.  OO 
(Hall's  Text-hook  of  Physiology.) 


(b)  Collins  and  Rockwell's  Physiology,  page  45. 

948.  (a)  By  what  means  is  the  heart  nourished?  (b)  How 
may  endocardiac  pressure  he  recorded? 

948.  (a)  Collins  and  Rockwell's  Physiology,  page  63. 
(b)  By  a  manometer  connected  with  a  cannula  inserted 
directly  into  the  cavity  of  the  auricle  or  ventricle,  the 
manometer  actuating  a  recording  style  giving  a  tracing  on 
blackened  paper  moving  at  a  uniform  rate  of  speed. 

949.  (a)  What  are  the  sources  of  the  heat  of  the  body?  (b) 
Through  what  channels  is  heat  lost  from  the  body? 

949.  (a)  See  Q.  439  to  445  (b).  (b)  Collins  and  Rock- 
well's Physiology,  page  141. 

950.  (a)  Describe  the  mucous  membrane  of  the  stomach. 
(b)  Mention  the  changes  that  take  place  in  the  gastric  glands 
during  secretion. 

950.  (a)  Collins  and  Rockwell's  Physiology,  pages  96 
and  97;  (b)  page  97. 


205 


APPENDIX. 


951.  Define  and  illustrate  (a)  osmosis,  (b)  diffusion,  (c) 
filtration. 

951.  (a)  Collins  and  Rockwell's  Physiology,  page  111. 
(b)  Diffusion  is  a  property  of  gases,  by  virtue  of  which  two 
or  more  gases  present  in  the  same  container  tend  individu- 
ally to  occupy  its  every  part,  resulting  in  the  intimate 
mixture  of  the  gases.  Example:  alveolar  air  in  the  lungs 
with  the  atmospheric  air  inspired,  (c)  Filtration  is  the 
process  of  a  liquid  or  gas  passing  directly  through  the 
pores  of  a  substance  dense  enough  to  arrest  solid  particles. 

952.  (a)  How  and  where  is  glycogen  formed  f  (b)  Explain 
the  condition  known  as  alimentary  glycosuria. 

952.  (a)  Collins  and  Rockwell's  Physiology,  pages  110, 
114  and  145.  (b)  If  a  person  takes  in  with  his  food  more 
sugar  than  the  liver  and  muscles  can  convert  into  glycogen, 
the  surplus  is  excreted  by  the  kidneys  and  appears  in  the 
urine;  this  is  called  ''alimentary  glycosuria.'' 

953.  What  is  the  difference  between  myopia  and  pres- 
byopia? 

953.  Collins  and  Rockwell's  Physiology,  pages  260  and 
261. 

954-  State  the  functions  of  the  pneumogastric  nerve. 

954.  See  Q.  498  to  500. 

955.  Give  the  normal  pulse,  temperature,  and  respiration 
at  (a)  birth,  (b)  the  age  of  21,  (c)  the  age  of  70. 

955. 


(a)  at  birth 
(6)  at  age  of  21 
(c)  at  age  of  70 


Pulse. 


130 

72 
65 


Temper  ATUKE. 


99°  to  99.7°  F. 

98.6°  F. 

99.7°  down  to  97°  F. 


Respiration. 


44 

16  to  20 

16  to  20 


956.  Describe   a   site   and  mention   the  requisites   for  a 
hospital  for  smallpox  patients. 


•Jo 


206  APPENDIX. 

956.  See  Q.  793  and  794. 

957.  How  may  milk  he  the  cause  of  disease?    Explain. 

957.  See  Q.  672  to  677. 

958.  (a)  What  hygienic  rules  should  he  ohserved  in 
hathingf    (b)  Give  a  description  of  a  Turkish  hath. 

958.  (a)  Egbert's  Hygiene  and  Sanitation,  page  286; 
(b)  page  287. 

959.  (a)  Mention  the  physiological  changes  that  take  place 
in  the  middle  period  of  life  in  woman,  (b)  What  hygienic 
rules  should  he  ohserved  at  that  time? 

959.  (a)  Collins  and  Rockwell's  Physiology,  page  274. 
(b)  ^^A  chief  point  is  to  keep  the  bowels  open,  preferably 
by  means  of  aperient  salts  or  waters.  .  .  .  Derivation 
to  the  skin  by  washing  the  whole  body  with  cold  water 
and  rubbing  the  skin  well  with  Turkish  towels  is  both 
pleasant  and  useful.  For  the  loaded  urine  it  is  good  to 
drink  a  siphonful  of  Vichy,  Rheus,  or  Seltzer  water  in  the 
course  of  the  day,  or  to  take  bicarbonate  of  soda  one-half 
drachm  in  a  tumblerful  of  water.  The  congestion  of  the 
head  and  visual  disturbance  are  often  much  benefited  by 
the  use  of  hot  footbaths,  with  or  without  mustard;  and  of  the 
cold  eye-douche  five  minutes,  three  times  a  day.  .  .  . 
A  lukewarm  general  bath,  taken  two  or  three  times  a  week, 
keeps  the  skin  in  good  order  and  tranquillizes  the  nerves. 
The  diet  should  be  bland,  but  must  vary  according  to  the 
constitution.  In  those  women  who  have  a  tendency  to 
stoutness  it  ought  to  be  as  much  restricted  as  possible,  and 
all  fat-producing  food  (cereals  and  sugar)  ought  especially 
to  be  taken  in  very  small  quantities;  milk  and  beer  are 

prohibited Those   more   exceptional   women 

who  lose  flesh  must  be  well  fed  and  have  chocolate  and 
plenty  of  milk  to  drink.  .  .  .  .  She  must  beware  of 
cold  feet  or  a  wet  skin  when  she  has  her  menses,  not  wash 
her  genitals  with  cold  water,  and  still  less  take  a  cold  bath 
when    the    menses    are    present She    should 


207  APPENDIX. 

abstain  from  sexual  intercourse.  When  first  the  menopause 
is  well  established  marital  relations  may  be  resumed.  The 
mental  diet  is  of  no  less  importance  than  the  physical. 
The  physician  may  relieve  much  unnecessary  anxiety  by 
giving  a  good  prognosis.  The  patient  should  occupy  her 
mind  by  useful  work,  and  likewise  as  much  self-control  as 
her  mental  condition  and  acquired  habits  will  allow.'' 
(Garrigues'  Diseases  of  Women.) 

960.  Compare  the  relative  merits  of  disposing  of  the  dead 
hy  (a)  burial,  (b)  incineration. 
960.  See  Q.  846. 


Questions  asked  June,  1904. 

961.  Define  (a)  physiology,  (b)  hygiene,  (c)  secretion,  (d) 
excretion,  (e)  function.    Illustrate. 

961.  (a)  Collins  and  Rockwell's  Physiology,  page  17; 
(b)  Egbert's  Hygiene  and  Sanitation,  page  17;  (c)  Collins 
and  Rockwell's  Physiology,  page  115;  (d)  page  115.  (e) 
A  fimction  is  the  characteristic  work  done  by  any  organ 
or  part  of  the  body ;  thus,  excretion  of  urine  is  the  function 
of  the  kidneys. 

962.  (a)  Mention  the  gases  found  in  the  blood,  (b)  What 
is  the  comparative  amount  of  these  gases,  and  (c)  what  dis- 
position is  made  of  them  in  the  process  of  nutrition? 

962.  (a)  Collins  and  Rockwell's  Physiology,  page  42; 
(b)  page  42.  (c)  Oxygen  is  carried  by  the  red  blood  cor- 
puscles and  given  up  to  the  tissues,  which  combine  with 
it  to  form  water;  and  carbon  dioxide,  which  is  taken  up 
by  the  blood  and  carried  back  to  the  lungs,  passes  by 
osmosis  and  diffusion  into  the  atmosphere. 

963.  Give  a  physiological  description  of  the  intestinal 
mucous  membrane. 

963.  Collins  and  Rockwell's  Physiology,  pages  101  to 
104. 


208  APPENDIX. 

964-  Describe  the  composition  and  the  function  of  (a) 
pancreatic  juice,  (b)  hile. 

964.  (a)  See  Q.  233;  (b)  Collins  and  Rockwell's  Physi- 
ology, pages  107  and  109. 

965.  Describe  the  action  of  the  diaphragm  in  (a)  respira- 
tion, (b)  hiccough,  (c)  vomiting. 

965.  (a)  See  Q.  171  to  173  (e);  (b)  see  Q.  173  (f);  (c) 
Collins  and  Rockwell's  Physiology,  page  101. 

966.  Differentiate  voluntary  muscles  and  involuntary 
muscles.    Illustrate. 

966.  See  Q.  56. 

967.  (a)  Mention  the  organic  constituents  of  food  sub- 
stances, and  (b)  state  how  these  constituents  should  be  pro- 
portioned for  the  maintenance  of  health  and  strength. 

967.  (a)  Collins  and  Rockwell's  Physiology,  pages  28 
and  29;  (b)  Egbert's  Hygiene  and  Sanitation,  page  228. 

968.  (a)  Describe  the  mechanism  of  patellar  reflex,  (b) 
Give  two  other  examples  of  reflex  action. 

968.  (a)  It  is  dependent  upon  the  integrity  of  (1)  an 
afferent  sensory  nerve  leading  to  (2)  a  centre  in  the  lumbar 
part  of  the  cord,  from  which  issue  (3)  efferent  fibres  dis- 
tributed to  the  quadriceps  extensor  femoris  in  such  a  way 
that  when  the  tense  patellar  tendon  is  struck  the  quadriceps 
is  reflexly  stimulated  to  momentary  contraction,  (b)  See 
Q.  474. 

969.  Give  a  general  description  of  the  organs  and  mech- 
anism concerned  in  the  production  of  the  voice. 

969.  See  Q.  455  to  459. 

970.  What  physiological  changes  take  place  in  the  uterus 
(a)  during  menstruation,  (b)  during  pregnancy,  (c)  after 
parturition? 

970.  (a)  '^Just  before  the  flow  the  membrane  becomes 
much  thicker,  congested,  and  thrown  into  shallow  folds. 
Then  it  undergoes   disintegration   by  fatty  degeneration, 


209  APPENDIX. 

and  is  thrown  off  with  the  blood  that  flows  from  the 
opened  capillary  bloodvessels.  There  exists  some  dis- 
crepancy of  opinion  as  to  how  much  of  the  mucous  mem- 
brane is  thrown  off  each  month,  but  no  doubt  exists  as 
to  the  fact  of  its  becoming  physiologically  hypertrophied 
just  before  the  menses,  and  of  its  undergoing  a  certain 
degree  of  fatty  atrophy  and  degeneration  during  and 
immediately  after  the  period.  Shortly  after  menstruation 
a  new  mucous  membrane  is  already  in  course  of  prepara- 
tion." (King's  Manual  of  Obstetrics.)  (b)  ''The  increased 
vascularity,  hypertrophic  thickening,  and  shallow  folding 
of  the  uterine  mucous  membrane,  which  begin  at  each 
menstrual  period,  progress,  after  the  stimulus  of  impreg- 
nation, with  rapidity.  The  membrane  becomes  extremely 
thick,  vascular,  and  deeply  convoluted  (except  near  the 
orifices  of  the  Fallopian  tubes  and  os  internum),  so  as  to 
obliterate,  or  almost  fill,  the  cavity  of  the  womb.  The 
hypertrophied  mucous  membrane  thus  formed  on  all  sides 
of  the  uterine  cavity  is  called  the  decidua  vera.  ...  In 
a  few  months  the  uterus  increases  in  size  (from  3  to  12 
inches  in  length;  from  IJ  to  9  in  width);  in  weight,  from 
about  an  ounce  to  about  two  pounds,  not  including  its 
contents.  The  capacity  of  its  cavity  is  enlarged  519  times. 
The  area  of  its  external  surface  is  increased  from  16  square 
inches  to  339  square  inches.  All  of  its  tissues — its  muscles, 
ligaments,  arteries,  veins,  lymphatics,  nerves,  and  nerve- 
ganglia — become  tremendously  hypertrophied.  The  uterus 
itself  changes  its  position,  prolapsing  during  the  first  two 
months,  and  gradually  rising  after  the  third."  (King's 
Manual  of  Obstetrics.)     (c)  See  Q.  577. 

971.  What  sanitary  provisions  should  be  considered  in 
deciding  on  a  method  of  heating  a  dwelling-house  f 

971.  Egbert's  Hygiene  and  Sanitation,  pages  115  et  seq, 

972.  State  in  detail  the  means  that  may  be  employed  to 
prevent  the  spread  of  epidemics  of  (a)  typhoid  fever,  (b) 
yellow  fever. 


210  APPENDIX. 

972.  (a)  See  Q.  641;  (b)  see  Q.  658. 

973.  Mention  the  four  conditions  {the  ^postulates  of  Koch) 
that  are  essential  to  prove  that  a  micro-organism  is  the  cause 
of  an  infectious  disease. 

973.  Egbert's  Hygiene  and  Sanitation,  page  53. 

974.  Give  in  detail  the  most  advantageous  method  for  the 
disposal  of  garbage  in  large  communities,  by  municipal 
authority. 

974.  Egbert's  Hygiene  and  Sanitation,  page  363. 

975.  What  is  (a)  natural  ventilation,  (b)  artificial  venti- 
lation? Mention  the  main  forces  concerned  in  each  of  these 
methods  of  ventilation. 

975.  (a)  Egbert's  Hygiene  and  Sanitation,  page  108;  (b) 
pages  108  and  119. 


Questions  asked  September,  1904. 

976.  Mention  the  differences  between  white  fibrous  tissue 
and  yellow  elastic  tissue  in  regard  to  structure,  distribution, 
and  function. 

976.  See  Q.  34. 

977.  Describe  the  manner  in  which  the  mammary  glands 
perform  their  functions. 

977.  '^The  cells  of  the  mammary  glands,  which  during 
pregnancy  become  active  for  the  first  time,  undergo 
histological  changes  of  such  a  nature  that  each  cell  increases 
in  size,  undergoes  a  fatty  metamorphosis,  the  nuclei  divide, 
and  then  a  portion,  at  least,  of  the  cell,  if  not  the  whole 
of  it,  disintegrates.  The  fragments  form  the  constituents 
of  the  milk.  There  are  known  instances  where  the  secre- 
tion of  milk  has  been  suppressed  by  strong  emotions, 
epileptic  attacks,  etc.,  indicating  a  control  of  the  central 
nervous  system.  The  connection  between  the  gland  and 
the  uterus,  which  stand  in  close  relation,  is  mainly  through 


211  APPENDIX. 

the  blood.  That  the  secretion  of  milk  may  be  continuous 
is  not  known  with  certainty,  but  it  is  probable  that  as  it 
accumulates  in  the  sacculated  ducts  of  the  gland  the 
tension  finally  inhibits  further  secretion.  The  emptying  of 
the  ducts  is  the  normal  stimulus,  either  directly  or  reflexly^ 
for  a  renewed  activity  of  the  gland.  Otherwise  the  cells 
undergo  retrogressive  changes,  but  they  never  become 
as  they  were  before  the  first  pregnancy."  (Guenther's 
Physiology.) 

978.  (a)  State  the  origin  of  fats  in  the  body,  and  (b)  give 
the  ultimate  fate  of  the  absorbed  fat. 

978.  (a)  ''The  origin  of  fat  was  at  first  supposed  to  be 
simply  that  which  was  taken  in  as  food,  but  the  history 
of  fat  as  seen  microscopically  showed  that  it  was  not 
simply  deposited,  and  it  was  soon  demonstrated  that  in 
cows  and  pigs  an  amount  of  fat  might  be  formed  out  of  all 
proportion  to  the  amount  ingested.  In  addition  to  this 
it  was  found  that  the  fat  of  an  animal  differed  in  kind 
from  that  which  was  taken  in  as  food.  It  has  been  defi- 
nitely decided  that  only  under  special  conditions,  as  when 
an  animal  is  richly  supplied  with  fats,  are  the  latter  stored 
directly.  Usually  the  fat  of  the  food  is  completely  oxidized, 
and  that  which  is  stored  is  derived  from  carbohydrates 
and  proteids.  The  latter  are  an  important  source;  the 
theoretical  maximum  that  tbey  can  yield  is  about  51.5  per 
cent.  It  has  been  shown  that  in  a  young  pig  the  amount 
of  fat  laid  on  in  a  given  time  was  greater  than  that  obtained 
from  the  food  directly,  plus  the  theoretical  maximum 
obtainable  from  proteids,  so  that  it  must  have  come  from 
the  ingested  carbohydrate  food.  It  is  of  interest  that 
the  Banting  diet  for  reducing  obesity  is  characterized  by 
the  absence  of  carbohydrates  and  the  excess  of  proteids.'^ 
(Guenther's  Physiology.)  (b)  The  ultimate  fate  of  the 
absorbed  fat,  after  being  conveyed  by  the  blood  to  the 
tissues,  is:  (1)  to  serve  as  a  source  of  energy,  (2)  as  a 
source  of  muscular  work,  and  (3)  to  help  in  the  main- 


212 


APPENDIX. 


tenance  of  the  body  temperature;  (4)  its  final  oxidation 
products  are  COg  and  H2O. 

979.  (a)  What  is  the  ordinary  composition  of  feces?  (b) 
Give  the  nervous  and  the  muscular  mechanism  of  defecation. 

979.  (a)  See  Q.  301;  (b)  See  Q.  303. 

980.  State  the  average  respiration  and  pulse  heat  a  minute 
and  give  the  average  temperature  of  (a)  the  newborn,  (b) 
the  youth,  (c)  the  adult,  (d)  the  aged. 

980. 


(a)  the  newborn 

(b)  the  youth 

(c)  the  adult 

(d)  the  aged 


Average 

Respiration 

A  Minute. 


44 
22 
18 
16 


Average 

Pulse-beat 

A  Minute. 


130 
90 

72 
65 


Average 

Temperature 

(in  Mouth). 

99.5°  F. 
98.8°  F. 
98.6°  F. 
99.0°  F. 


981.  Give  the  specific  gravity,  reaction,  temperature,  and 
microscopic  character  of  the  Mood. 

981.  Collins  and  Rockwell's  Physiology,  pages  31  and  32. 

982.  Give  a  comprehensive  description  of  the  processes  hy 
which  digested  food  is  absorbed. 

982.  Collins  and  Rockwell's  Physiology,  pages  111  to 
114. 

983.  Describe    (a)    the  cornea,    (b)    the   iris.      State   the 
functions  of  each. 

983.  (a)  Collins  and  Rockwell's  Physiology,  pages  246 
and  247;  (b)  pages  248  and  259. 

984-.  What  is  the  physiology  of  (  )  hunger,  (2)  thirst  f 

984.  See  Q.  535. 

985.  (a)  Mention  the  nutritive  fluids  of  the  body  and  (b) 
state  the  functions  of  any  one  of  those  mentioned. 

985.  (a)  The  nutritive  fluids  are  chyle,  blood,  and  lymph. 
(b)  Collins  and  Rockwell's  Physiology,  pages  46  and  47. 


213  APPENDIX. 

986.  Describe  a  method  of  disinfecting  excreta,  the  'person 
of  the  convalescent,  the  clothing,  and  the  vacated  sick-room. 

986.  See  Q.  824. 

987.  Mention  the  reliable  sources  of  a  pure  water  supply. 

987.  See  Q.  701. 

988.  Mention  the  communicable  diseases  that  come  within 
the  scope  of  public  health  administration. 

988.  The  diseases  required  by  the  New  York  State 
Department  of  Health  to  be  reported  are :  Asiatic  cholera, 
yellow  fever,  typhoid  fever,  typhus  fever,  smallpox,  scarlet 
fever,  measles,  diphtheria,  and  membranous  croup.  In 
addition  to  the  above  diseases,  the  New  York  City  Depart- 
ment of  Health  requires  the  reporting  of  chickenpox, 
membranous  croup,  spotted  fever,  relapsing  fever,  con- 
sumption, and  malaria. 

989.  Describe  (a)  the  care  of  the  person  in  the  tropics  as 
to  (b)  clothing,  (c)  diet,  (d)  habits  of  life  and  (e)  use  of 
alcohol.     Give  reasons  for  conclusion. 

989.  (a)  "Care  of  the  Person. — The  irritating  effect  of 
hot  winds,  which  frequently  carry  fine  particles  of  sand 
and  dust,  and  the  glare  of  the  sun,  which  conduces  to 
troubles  with  the  eyes,  should  be  guarded  against.  Not 
infrequently  the  ears,  too,  are  affected  injuriously  by  hot 
winds,  but  they  are  easily  protected  by  external  coverings 
or  by  cotton-wool  plugs.  The  nose  and  lips  are  subject 
to  cracking  and  luicomfortable  dryness,  which  may  be 
helped  by  cold  cream  or  some  similar  application.  The 
nails  should  be  kept  closely  pared,  since  they  become 
brittle  and  crack  off.  The  skin,  having  a  very  important 
function  to  fulfil,  should  be  kept  thoroughly  clean,  if  on 
no  other  account;  but  bathing  in  too  cold  water  or  for 
too  long  a  time  should  be  avoided.  Parasites  abound  in 
tropical  climates,  and  should  be  looked  for  on  the  person 

and   removed   with   all   care Diarrhoea   and 

constipation  are  alike  to  be  avoided.    The  former  should 


26 


214  APPENDIX. 

be  checked  at  once,  and  should  on  no  account  be  allowed 

to  continue  without  treatment Constipation 

should  be  avoided  by  the  acquirement  of  a  regular  habit/' 
(b)  ^^  Clothing. — One  is  advised  to  take  plenty  of  light 
cotton,  linen,  and  merino  underwear,  a  generous  assort- 
ment of  trousers  and  coats  of  white  duck  or  flannel,  and 
light  merino  stockings.  High  boots,  well  oiled  and  with 
hob-nails,  laced  boots,  leggings  of  cloth  and  leather,  and 
light  footwear  for  indoor  and  city  use  should  be  included. 
Light  waterproof  outer  garments  with  cape  and  hood  are 
recommended,  and,  for  protection  against  the  sun,  white 
umbrellas  lined  with  blue  or  green  material,  and  spectacles 
with  green  or  blue  colored  glasses.  The  head-covering 
should  be  selected  with  the  double  consideration  of  comfort 
and  protection  for  the  head  and  neck.    A  puggery  affords 

additional  protection If  one  is  to  do  much 

riding,  it  is  advised  that  as  much  care  be  expended  in  the 
selection  of  a  saddle  as  in  selecting  boots,  since  comfort 
in  horseback  riding  in  the  tropics  is  very  largely  dependent 
upon  the  fit  of  the  saddle."  (c)  "Diet. — The  question  of 
diet  in  the  tropics  is  a  very  serious  one,  for  errors  may 
be  followed  by  disastrous  results.  Since  prolonged  heat 
exerts  an  unfavorable  influence  on  digestion,  this  function 
should  not  be  made  to  bear  too  heavy  a  burden,  and  it 
becomes  necessary  to  restrict  the  diet  in  several  particulars. 
No  more  food  should  be  taken  than  can  comfortably  be 
digested,  for  both  dysentery  and  diarrhoea  are  favored 
by  the  irritation  caused  in  the  intestines  by  food  partially 
digested  or  undergoing  fermentative  processes.  But  the 
change  from  the  accustomed  diet  should  not  be  made 
with  too  great  abruptness.  The  natives  depend  chiefly 
upon  a  vegetable  diet,  in  which  rice  and  beans  and  fruits 
of  all  kinds  play  prominent  parts.  Meat,  if  eaten  at  all, 
is  taken  usually  in  very  small  quantities.  As  a  rule,  in 
hot  climates,  it  is  not  tender,  for  it  cannot  be  hung  days 
and  weeks,  as  with  us,  to  ripen,  but  must  be  cooked  and 
eaten  within  a  very  few  hours  after  slaughtering.     Fish 


215  APPENDIX. 

should  not  be  used  unless  very  fresh,  and  shell-fish  of  all 
kinds  should  be  avoided.  Fresh  milk  is  ordinarily  not 
to  be  had  or,  at  least,  is  difficult  to  obtain.  It  speedily 
sours  and  becomes  unfit  to  drink.  Condensed  milk  of  good 
quality  is  more  to  be  depended  upon.  Vegetables  should 
be  thoroughly  cooked,  or  they  will  seriously  tax  the 
digestive  organs.  Fruits  should  be  perfectly  ripe  and 
sound;  overripeness  is  quite  as  objectionable  as  greenness. 
Overindulgence  in  fruit,  even  of  the  best  quality,  and 
especially  in  the  sour  fruits,  is  particularly  to  be  avoided. 
Tea,  coffee,  and  chocolate  are  advised  in  moderation. 
Lime-juice  with  water  or  cold  tea  makes  a  most  refreshing 
drink.  Tamarinds  in  water  are  also  most  grateful.'' 
(d)  "  Hahits  of  Life. — All  authorities  agree  in  at  least  one 
particular,  and  that  is,  in  urging  moderation  in  all  things 
— diet,  drink,  work,  exercise,  dress.  The  diet  should  be 
chosen  with  care,  and  iced  drinks  taken  in  great  moderation, 
if  at  all.  The  ^clothing  should  be  chosen  with  judgment 
both  as  to  protection  from  the  heat  of  the  sun  and  against 
chilling  of  the  body.  Work  should  not  be  excessive,  nor 
should  it  be  performed  in  the  sun  during  the  hottest  part 

of   the  day One  should  never  go  out  with 

an  empty  stomach  nor  do  work  immediately  after  a  meal. 
After  dinner,  a  walk  or  some  form  of  recreation  until  10.30 
or  thereabouts,  which  is  the  proper  time  for  retiring. 
One  is  advised  strongly  not  to  expose  one's  self  to  the 
cool  external  night  air;  to  avoid  cold  bathing  and  cold 
drinks  while  perspiring,  and  especially  to  avoid  standing 
for  a  long  time  in  the  shade  in  garments  wet  with  perspi- 
ration. If  one  is  compelled  to  be  exposed  to  the  sun  for 
long,  the  protection  afforded  by  umbrellas  and  colored 
spectacles  against  heat  and  glare  should  be  sought.  The 
consequences  of  exposure  may  be  exceedingly  severe  or 
even  fatal."  (e)  ''The  Use  of  Alcohol  in  the  Tropics. — 
Writers  on  tropical  hygiene  are  almost  unanimous  in  the 
opinion  that,  whatever  may  be  said  for  and  against  the 
use  of  alcoholic  drinks  in  other  climates,  their  use  in  the 


216  APPENDIX, 

tropics  constitutes  a  distinct  danger,  and  that  much  of 
disease  commonly  attributed  to  chmate  is  due  actually 
to  alcohol.     Especially  is  this  true  of  the  various  renal 

and  hepatic  troubles If   alcohol  in  any  form 

is  desired,  the  light  wines  diluted  with  water  are  recom- 
mended more  highly  than  beer.  Spirits  are  generally 
condemned,  but  there  appears  to  be  no  valid  reason  why, 
when  very  largely  diluted  with  water  or  soda  water,  they 
should  exert  a  more  pernicious  influence  than  wine  only 
moderately  extended.  In  any  event,  alcohol  should  be 
taken  only  with  food."    (Harrington's  Practical  Hygiene.) 

990.  What  hygienic  methods  may  he  employed  to  prevent 
diphtheria? 

990.  See  Q.  630  to  632. 


"V* 


